To link to the entire object, paste this link in email, IM or documentTo embed the entire object, paste this HTML in websiteTo link to this page, paste this link in email, IM or documentTo embed this page, paste this HTML in website

THE LIBRARY OF THE
UNIVERSITY OF
NORTH CAROLINA
AT CHAPEL HILL
THE COLLECTION OF
NORTH CAROLINIANA
C61U
N86
1930-3U
C.2
This book is due on the last date stamped
below unless recalled sooner. It may be
renewed only once and must be brought to
the North Carolina Collection for renewal.
form rvo. (is-.^oy
MR. JRC. G. BEAPDf
CFAPEL HILL» H. C u.
^HfedMb 'IEjqiiI
Thi5 Bdlelirvwillbe 5er\t free to arwj citizen of the State upo:\ request.
|
Entered as second-class matter at Postoffice at Raleigh, N. C. under Act of July 16, 1S9U
Published monthly at the office of the Secretary of the Board, Raleigh, N. C.
Vol. XLIX JANUARY, 1934 No. 1
NORTH CAROLINA HEALTH CALENDAR
for 1934
Some Things Our Citizens Should Endeavor To Do
1. Reduce the infant death rate.
2. Reduce the maternal death rate.
3. Extend organized health service to every county.
4. Increase the per capita consumption of safe milk.
5. Work for the day when no citizen shall suffer or die from a pre-ventable
disease.
6.
8.
9.
10
Continue the efforts to completely eradicate pellagra and small-pox.
Immunize every baby in the State against diphtheria at Six
months of age.
Extend the benefits of approved sanitary facilities to include
every rural home.
Provide competent prenatal medical seivice and medical care
for all maternity cases.
Through regular and thorough medical examination and consist-ent
medical care prevent untimely deaths from such killers as
cancer, tuberculosis, and the many diseases of heart and kidnejs.
11. Secure a more widespread system of medical supervision of the
health of school children, with a more effective system of follow-up
which will provide for the removal of all remediable physical
handicaps; and care for every malnourished child in the com-monwealth.
12. Strive for a health-minded population who will eventually realize
the benefits of positive health, and who will be just as willing to
pay for competent medical and dental service when needed to
preserve good health as they are now ready to pay out money
for any of the other desirable possessions of life.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
Carl V. Reynolds, M.D., President Asheville
G. G. Dixon. M.D ' Ayden
S. D. Craig. M.D Winston-Salem
H. Lee Large, M.D Rocky Mount
J. N. Johnson, D.D.S Goldsboro
H. G. Baity. Sc.D Chapel Hill
W. T. Rainey, M.D Fayetteville
Hubert B. Haywood, M.D Raleigh
James P. Stowe, Ph.G Charlotte
Executive Staff
James M. Parrott, M.D., Secretary and State Health Officer.
G. M. C00PE3S, M D., Director Division of Preventive Medicine.
Warren H. Booker, C.E., Director Division of Sanitary Engineering.
Ernest A. Brakch, D.D.S., Director Division of Oral Hygiene.
John H. Hamilton, M.D., Director Division of Laboratories
and Vital Statistics.
M. V. ZlEGLER, M.D., Actinsr Director Division of County
Health Work.
D. F. Milam, M.D., Acting Epidemiologist.
FREE HEALTH LITERATURE
The State Board of Health publishes monthly The Health Bulletin
which will be sent free to any citizen requesting it. The Board also has
available for distribution without charge special literature on the follow-ing
subjects. Ask for any in which you may be interested.
Adenoids and Tonsils
Cancer
Constipation
Chickenpox
Diabetes
Diphtheria
Don't Spit Placards
Eyes
Flies
Fly Placards
German Measles
Health Education
Hookworm Disease
Infantile Paralysis
Influenza
Malaria
Measles
Pellagra
Residential Sewage
Disposal Plants
Sanitary Privies
Scarlet Fever
Smallpox
Teeth
Tuberculosis
Tuberculosis Placards
Typhoid Fever
Typhoid Placards
Venereal Diseases
Water Supplies
Whooping Cough
SPECIAL LITERATURE ON MATERNITY AND INFANCY
The following special literature on the subjects listed below will be sent
free to any citizen of the State on request to the State Board of Health,
Raleigh, N. C.
Prenatal Care (by Mrs. Max West)
"Our Babies"
Prenatal Letters (series of nine
monthly letters
)
Minimum Standards of Prenatal Care
Breast Feeding
Infant Care. The Prevention of
Infantile Diarrhea.
Table of Heights and Weights
Baby's Daily Time Cards : Under 5 months ;
5 to 6 months ; 7, 8, and 9 months ; 10,
11, and 12 months; 1 year to 19 months;
19 months to 2 years.
Diet List: 9 to 12 months; 12 to IB
months ; 15 to 24 months ; 2 to 3
years ; 3 to 6 years.
Instructions for North Carolina Midwives.
CONTENTS
page
Notes and Comment 3
Rules and Regulations for the Control of Psittacosis 6
About First and Latest Presidents N. C. State Board of Health 7
Infectious Diseases We Don't Talk About 9
Eating Habits - - ^^
North Carolina Turns Over a New Leaf in Public Health 13
Amoebic Dysentery ^^
Ignorance More Malignant Than Cancer - - 16
Suggested New Year Resolutions 16
PUBLI5AE:D by TML noR.TA CAeOLIMA 5TATL BQAIgP s^AEALTM
Vol. XLIX JANUARY, 1934 No. 1
Notes and Comment
ANEW YEAR lies before us. A
new year with new possibili-ties,
new liabilities, new adven-tures,
new disasters, and new oppor-tunities
spreads out before us like an
unknown road. The only criterion we
have for intelligent speculation as to
what mankind may expect during this
new year is by a study of what the
innumerable new years of the past
have disclosed. In many respects this
new year begins at a time when con-ditions
all over the world are probably
more disturbed than at any other time
since the beginning of recorded his-tory.
The years of the World War
were upsetting, but many thickly pop-ulated
regions of the earth scarcely
knew what was going on. The years
of the American Revolution and of the
French Revolution upset the world
very largely, and yet such densely
populated countries as China knew
nothing of what was going on outside
of their own country. At present there
is not a civilized or half-civilized
country in the world but what is in
an unstable condition.
For our own country, and for North
Carolina in particular, our concern is
tor the protection of the public health.
It is interesting to note a comparison
which may or may not be altogether
to the credit of the present organiza-tion
of the State Board of Health.
The reason we make that statement is
that the present organization have
means and personnel which were lack-ing
twenty-five years ago. Twenty-five
years is not a very long period as time
is recorded. In The Health Bulletin
for January, 1909, just twenty-five
years ago, among other things, the
late Dr. Richard H. Lewis, at that
time Secretary of the Board and State
Health Officer, printed the following
appeal to the General Assembly, then
in session:
"The great work is the general work
of the Board of Health. A sine qua
non in the proper performance of this
work is a competent Secretary, who
shall be required to devote his whole
time to it. Such a man, one who has
proven himself a success, cannot be
obtained for less than three thousand
dollars a year. He should have a good
assistant for the office work, while he
is absent, investigating outbreaks of
disease and educating the people by
public addresses and by advice to
health boards and health officers. This
assistant should also have charge of
the collection and tabulation of vital
statistics. A first-class stenographer
is a prime necessity."
Doctor Lewis, in this editorial,
points out that his total income as
State Health Officer was $750, that he
had to make his living by the practice
of medicine, and that as a consequence
the health work of the State had nec-essarily
been a side issue and a sec-ondary
matter. Doctor Lewis speaks
of "health officers." He meant part-time
physicians. There was not a
whole-time health officer in the State
at that time, and not until many years
afterward.
Be it said to the credit of the Gen-eral
Assembly, it responded with en-thusiasm
to Doctor Lewis's appeal and
made provision for a whole-time State
Health Officer and an "assistant for
office work," and a "first-class stenog-rapher,"
which Doctor Lewis was
pleading for, and a lot more. On July
1st following. Dr. W. S. Rankin, the
The Health Bulletin January, 1934
State's first whole-time State Health
Officer, assumed his duties. Today
there is an average of about eighty-five
whole-time employes of the State
Board of Health. In place of an office
assistant to "have charge of the collec-tion
and tabulation of vital statistics,"
there are about eighteen whole-time
employes in that department alone.
At present there are about ten stenog-raphers
instead of the one first-class
stenographer Doctor Lewis was re-questing.
The question for the present organi-zation
is this: Have we, In accordance
with the opportunities which have
been ours for the work of the public
health, done as much with our means
as Doctor Lewis accomplished with his
$250-a-year statistician? We leave it
to the people of North Carolina to
render judgment. Doctor Lewis's
chief contribution was in the building
of a foundation of good-will and the
creation of a desire on the part of the
people for the right kind of public
health service.
We hope that the contribution of
the present organization has measured
up fully to what might have been ex-pected
of it. We know that some dis-eases
have been almost eliminated;
some diseases which were very preva-lent
twenty-five years ago have become
rare at this time. Twenty-five years
ago we had no means of preventing
diphtheria; we had no means of pre-venting
typhoid fever, except through
sanitation; we had the means for pre-venting
smallpox, but for lack of or-ganization
and money to pay for pub-lic
health service that disease was
very prevalent. Many deaths occurred
every year. At this time we still have
diphtheria with us. We do not yet
have a tabulation of deaths occurring
in 1933 from diphtheria, but we know
there were a large number that could
and should have been prevented. Al-though,
by means of preventive treat-ment
and improved sanitation every-where,
typhoid fever has been greatly
reduced, it is still prevalent in many
sections of the State. The eradication
of preventable diseases is a slow and
tedious process. Practical knowledge
about how to prevent disease and how
to protect one's health is educational
matter in which each individual may
obtain information for himself. Health
education is a perennial interest; the
story has to be repeatedly told, and
our work is not yet done. It never
will be finished.
If we are able to make the same
progress during the next twenty-five
years that we have in the last twenty-five,
in January, 1959, some future
editor of The Health Bulletin may
be writing in these columns that ty-phoid
fever, diphtheria, tuberculosis,
and all the other preventable diseases
are gone from the confines of North
Carolina. Let us hope that the part
we may play this year will advance
the cause more than any other year in
the past.
* * *
FROM time to time we have called
attention in The Health Bulletin
to the menace of trichinosis, that is,
a parasitic infection in pork. We try
to do this sometime during every
winter in order to warn our folks who
might be inclined to eat their pork
raw, or half-cooked. Outbreaks of
this malady occur at frequen,t inter-vals
all over the country. It is caused
by a parasite in hogs, and it is said
that between 2 to 5 per cent of all the
hogs in the United States are infected.
Infected pork has been discovered
in practically every section of the
country at one time or another. There
is no present method of meat in-spection
which will discover the pres-ence
of this parasite. We mention
this so that people in the cities and
towns will place no reliance whatever
on a meat inspection service. The
meat inspectors in all of the larger
cities and towns of the State protect
,
the people from many sources of dis-ease
by discovering meat that is not
fit for human consumption; but, as
just stated, there is no form of inspec-tion
yet discovered which will enable
an inspector to find the evidence of
trichina in the meat. With the ever
increasing consumption of "hot dogs"
and other half-cooked or downright
raw pork at all kinds of roadside
stands all about over the State, it is
very necessary to put people on their
V
Januai-y, 193Jf The Health Bulletin
guard against this infection. Once the
parasite is established in the tissues
of the human body, it is very hard to
eradicate. There is no known medical
treatment which is effective in curing
a patient. In many cases the symp-toms
of the disease are very similar
to typhoid fever.
Late in the summer, in Westchester,
New York, the health officer for that
county reports that nine families,
comprising thirty-four individuals, all
mutually acquainted, spent a few days
at a camp. Later all suffered from
the disease. They had the customary
habit of many campers, of building a
camp-fire and cooking their own food
outdoors, specializing in frankfurters
and hamburgers, the latter composed
of about three parts of beef to one
part of pork. Cooking before an open
fire outdoors naturally meant that the
food was not even half-cooked. Other
sections of the country have reported
having had trouble with this infection
from time to time; for example, the
Connecticut Board of Health has re-cently
reported 107 cases of the dis-ease
having occurred in that state
during the past ten years. The para-site
is easily destroyed by cooking the
meat thoroughly before eating it. The
main danger in outdoor cooking and
in cooking pork sausage and so on in
frying pans is that the outside portion
may be cooked sufficiently hot, heating
to 145 degrees or more, which will de-stroy
the parasite; but the inside of
the portion, not being heated to any
such temperature in a shallow pan or
before an open fire, is not thoroughly
cooked, and the parasite is not killed;
therefore, infection easily follows eat-ing
such half-cooked meat.
The purpose of this mention here is
to urge upon people again, for their
own protection, the importance of
thoroughly cooking all pork before it
is eaten.
* * *
RIDING along the road the other
day in Cumberland County, the
editor noticed a roadside sign which
read something like this: "One mile
to John Smith's gristmill and dairy."
If such a sign could be located about
every ten miles on all public roads in
North Carolina, deficiency diseases,
such as pellagra, would soon become
but a memory. This sign, indi-cating
a plentiful supply of freshly
ground corn-meal from sound native
corn, and fresh milk and all the dairy
products that go with it, reminded
the editor that Dr. James A. Tobey
sometime ago wrote a very interest-ing
article under the title of "Bread,
the Universal Food." Doctor Tobey
made the following statement: "Mal-nutrition
can be averted at all times,
and especially in periods of economic
stress, by following one simple rule.
According to the consensus of scien-tific
opinion, it is merely this: build
the daily diet around bread and milk."
That should be the ticket for North
Carolina this coming year: build the
daily diet of every family around milk
and bread. Bread does not necessarily
mean corn-bread alone, but white-flour
bread, whole-wheat bread—bread of
different kinds. Add to this the nec-essary
variety of vegetables, eggs,
fruit, and some meat, and any family
has a diet that protects, provides fuel
and energy for the daily needs of
adults, and for the health and growth
demands of growing children. In
short, this Cumberland County road-side
mill and dairy owner is prepared
to supply to his neighbors and cus-tomers
the elements which Doctor
Tobey considers the foundation of the
daily diet. All the rest should be
built around that.
* * *
THE editor's official duties took him
about a good bit over the State
during the fall, and always on the
alert for items which would be bene-ficial
to the readers of The Health
Bulletin, he makes it a point to look
about him on his travels. Late in
November he had occasion to visit
several points in Eastern North Caro-lina.
Passing through one fine little
town about one o'clock, and noticing
that the town looked so clean and the
odors around the hotel were so appe-tizing,
he pulled up to the curb and
parked and decided to take his midday
meal right there. Opening the door, he
entered the coffee shop of the local
hotel from the street entrance. He
The Health Bulletin January, 193Jf
stepped into as clean and appetizing
place as he has visited in a long time.
The room and the floor and the tables
and the linen were all spotless. The
food was well prepared, well balanced,
clean, and wholesome. As the day was
cold, the editor yielded to what some
people would call his "bad habit," and
called for a cup of coffee. It came
steaming hot, and looked good. Ac-companying
the coffee, however, was
a tiny container about two-thirds full
of milk. Eastern North Carolina sim-ply
will look on milk as too precious
for human consumption. Fixing the
coffee up, however, and getting ,i taste,
he discovered that the milk was
canned condensed milk, something
that he could never endure. It well-nigh
destroyed the joy in the meal
entirely. The thought of having to
put up with canned condensed milk
in a section that should be literally
flowing with milk and dairy products
was too much.
Now here comes the funny part of
the experience. More or less deter-mined
to have his coffee anyhow, he
requested the waitress to take the
oily, greasy, condensed-milk mixture
back and to bring along some plain
coffee. She readily agreed, but like a
good waitress inquired the trouble.
On being told, she replied: "Oh, we
have some fresh milk if you prefer it."
She returned to the refrigerator and
brought out from a carefully hidden
corner about a thimbleful. So the
editor got his coffee flavored, at least,
with fresh milk. Further inquiry
brought out the information that most
of their customers took their coffee
straight or preferred condensed milk;
but during the last year or two "more
cranks seemed to be coming along
who insisted on fresh milk." And
frankly she did not like the way these
"cranks" insisted on Grade A Milk.
The reader may imagine the editor's
delight that night on reaching his
destination late and cold in another
fine little town still farther east, on |
walking into the hotel restaurant,
to see State Board of Health post-ers
all over the place announcing
"Grade A Milk Sold Here." And when
the coffee came in it was accompanied
by a man-sized pitcher of real fresh
cream. What with some of the finest
trout fresh from the sea and superbly
cooked—but that is another story.
Now, that Governor Ehringhaus has
succeeded in getting the farmers of
the eastern section a living price for
their tobacco, perhaps he can induce
them to invest some of their surplus
cash in good milk cows. What a
break that would be for the many
thousands of fine children who need
milk for proper growth, but who do
not get it now.
Psittacosis
Rules and Regulations for the Control of Psittacosis
BY virtue of the authority vested
in the North Carolina State
Board of Health, under Consoli-dated
Statutes, Chapter 118, Public
Health, Article 9, Section 7151 to Sec-tion
7155, the State Board of Health,
on August 15, 1933, declared psittacosis
to be an infectious disease; and sub-ject
to laws and regulations governing
notification and methods for dealing
with sources and modes of infections
of such diseases.
NoTiFrcATiON : 1. Cases of psittaco-sis
must be reported within twenty-four
hours—preferably by telephone
or telegraph.
Isolation: 2. The patient sick with
psittacosis shall be isolated in a sepa-rate
room, and no person other than
the local health officer or his repre-sentative
or a representative of the
State Board of Health, the attending
physician, the nurse, or attendant,
shall be permitted to enter the room
in which the patient is isolated or
quarantined.
In the event a friend or member of
the family should desire to be with
January, 193-'t The Health Bulletin
the sick one, such a person shall re-main
in quarantine for such a time
as the local or State Health Depart-ment
may determine.
Concurrent disinfection of all dis-charges
and articles must be carried
out and terminal disinfection insti-tuted.
Quarantine: 3. The premises in
which the patient is isolated are to be
placarded and quarantine instituted
until complete clinical recovery or
death of the patient.
Contacts: 4. It is advised that
household contacts be kept in quaran-tine
for at least five days following
last exposure, and under close obser-vation
for at least three weeks. The
exact incubation period of psittacosis
is unknown, but can be very long and
drawn out. Less intimate contacts
should be kept under careful observa-tion
as far as possible.
Birds: 5. Canaries, macaws, par-rots,
parrakeets, and other psittacine
birds that have been exposed to psitta-cosis,
either through birds known to
be infected with psittacosis or having
been associated with birds proven to
be probable sources of human cases,
must be killed and burned promptly.
This measure is to be ordered either
by the city, county, or State Depart-ment
of Health in each case, and no
indemnity provided.
Birds not of the psittacine family
are all to be regarded as potentially
dangerous when they have been ex-posed
to psittacosis, and after expo-sure
must be kept under close super-vision
and quarantine for a period of
not less than three weeks, and then
released only if no sign of psittacosis
has occurred amongst them.
Shipment: 6. Shipment of birds
into North Carolina by any means of
transportation whatever shall conform
to the regulations of the Federal Gov-ernment
covering this point.
The above rules and regulations
were adopted and approved by the
Executive Committee of the State
Board of Health in session on Decem-ber
5, 1933, and ordered promulgated.
James M. Pakrott,
Sec.-Treas., State Board of Health,
and State Health Officer.
About Fir^ and Late^ Presidents N. C. State
Board of Health
BEFORE we had time to comment
on the editorial of Editor Peter-son
in his journal for September
1st about Dr. Satchwell, our friend,
John M. Gibson, editor of the Sanato-rium
Sun, came along in his October
issue quoting the editorial as follows:
"The following brief article, headed
'A Great Old Physician,' appeared in
The State's Voice for September 1,
and no doubt will be of much interest
to patients, ex-patients, and friends
generally of the N. C. Sanatorium:
" 'My mind was carried back to a
great old physician when I met Quin-cey
Satchwell the other day. He is a
son of Dr. S. S. Satchwell, who died
nearly two score years ago. Dr. Satch-well
was one of the few physicians in
the State who had studied abroad.
He was a graduate of a Paris univer-sity,
and it was over there that lie
got the poison in his system that af-fected
his nose in such a way as to
make him a marked man for the rest
of his life.
" 'Highly educated as he was, and
skillful physician that he was, he
spent the greater part of his life in
country or village practice. He was
an old man when I went to Burgaw
as a teacher forty-one years ago, but
he was still intellectually strong. The
theory of ozone as a product of the
pitch-pine forests was Dr. Satchwell's,
if I mistake not. Anyway, he was a
champion of it, and that doctrine, with
the inferred effects upon consumption
of residence in the pine belt, had no
little influence in turning the one-time
flow of consumptives to the sandhills
of North Carolina, whatever merit
8 The Health Bulletin January, 193ff
there was, or is, in the theory. The
theory is probably responsible, also,
for the location of the State Tubercu-losis
Sanatorium where it is.'
"
This was a most interesting re-minder
to us for the reason that Dr.
Satchwell was the first member of the
N. C. State Board of Health and its
first president. Both Editors Peterson
and Gibson failed to mention that fact,
possibly because neither knew about
it. So, for the benefit of all of our
readers, we quote the following para-graph
from a paper written by the
editor of The Health Bulletin a few
years ago:
"On May 23, 1877, during the meet-ing
of the North Carolina Medical So-ciety,
which was held that year at
Salem, North Carolina, Dr. S. S. Satch-well,
of Rocky Point, Pender County,
was made the first president of the
State Board of Health, and Dr.
Thomas Fanning Wood its first secre-tary,
these ofiicials being designated as
'chairman' and 'secretary,' respec-tively,
of the committee of the State
Medical Society having in charge the
fortunes of the newly proposed State
Board of Health. This meeting was
immediately following the adjourn-ment
of the Legislature that year, at
which time the first law creating the
board was enacted. It may be inter-esting
to note in passing that on that
occasion Dr. Satchwell read an impor-tant
paper entitled, 'Duties and Use-fulness
of the State Board of Health.'
This paper made such an impression
that the society voted unanimously to
remit all dues to Dr. Satchwell for
the remainder of his life 'as a slight
testimonial of the regard of the so-ciety.'
On that day the first machin-ery
of organizing the State Board of
Health was definitely set in motion."
On Monday, November 13, 1933, Dr.
Carl V. Reynolds, of Asheville, was
elected president of the State Board
of Health. From May 23, 1877, to
November 13, 1933, is not a very long
period, as time is measured; but much
history has been made by the State
Board of Health in those fifty-six
years. Not many men have served as
president of this organization, possi-bly
a half-dozen, and not one of them
has been held in higher esteem by his
fellows than Dr. Satchwell, its first
president. Dr. Reynolds has been a
valued member of the Board for two
years, but, of course, he has not yet
had an opportunity to establish a
reputation as president. However, he
is not without a record in his home
town. Lest the editor, as a minor
employe of the Board, be suspected of
"boot-licking" his chief, we will let
the Asheville Times present the new
president to our readers:
"A pioneer in public health work is
again deservedly honored in the unani-mous
election of Dr. Carl V. Reynolds, ,
of Asheville, as president of the North \
Carolina State Board of Health.
"Those who knew not the Asheville
of the nineties nevertheless have
heard how Dr. Reynolds, as city health
officer, put Asheville on the public
health map of the United States.
"He had peculiar gifts for the work,
and especially for the unceasing,
never-wearying, many-sided educa-tional
labors which public health in
those days demanded far more than
now.
"Health Officer Reynolds stirred up
the professional brethren, and the alert
and the lazy laymen, on such subjects
as pure milk, the wrapped loaf, and a
vigorous warfare on the housefly.
"His bacteriologist and field mar-shal
was the late Dr. L. M. McCor-mick,
and Reynolds and McCormick
swatted the fly with swats that, if not
heard around the world, were heard
all around the United States. Before
that battle began in Asheville, most
people in this country had accepted
the common fly as part of the common
fate that had to be endured, no mat-ter
what the cost.
"This is recalled here to emphasize
once more the State's good fortune in
having Dr. Reynolds on the State
Board of Health. The Board's work
is now severely limited in some phases
of it by the general trimming down
of the State budget. Dr. Reynolds
can be counted upon to cry aloud and
spare not in arousing the people to
preserve what they have in public
health achievements, and to press on-ward
at every opportunity."
January. 1934 The Health Bulletin
Infedlious Diseases We Don't Talk About
By Wm. D. Riley, Consultant, Venereal Disease Control
THERE seems to be an instinctive
disposition on tlie part of most
people to avoid looking unpleas-ant
facts in the face. This disposition
is manifested not only when individ-uals
are confronted with the daily
problems of life, but it is also all too
frequently evidenced in problems of
disease. Especially is this true in the
case of that group of infectious dis-eases
known as venereal, of which
syphilis and gonorrhea are the most
important as public health problems.
The idea that the venereal diseases
are spread through intimate personal
contact has seemed and still seems re-pugnant
to some minds. But this re-pugnance
is due, perhaps, to a confu-sion
of thought in those minds rather
than to any essential objection in the
conception of these diseases.
Because of this confusion of thought
the venereal diseases have too long
been camouflaged under the term "so-cial
diseases," a term which justly in-cludes
all infectious diseases. While
the origin of this term can be readily
understood by even the most unimag-inative,
when used in this way it is an
unfortunate commentary on human
nature. It is true that essentially we
are social. Indeed, if we are to live
our lives fully and completely we must
be socially inclined. In order to main-tain
our balance of sanity and health
it is quite necessary that we share
the warm companionship of our fel-low
beings. Without this desire for
social contact, or when shunned by
society, people eventually fall subject
to mental disorders, usually. Some-one
has said that the three great hu-man
drives are "being social, occup?.-
tion, and love." Being social includes
the other two. But the ironic part of
it is that in being social so much trag-edy
frequently descends upon man.
Due to the fact that the venereal
diseases are spread largely through
sex contact, they have, until recent
years, been looked upon as the skele-ton
in the closet of society. They were
considered the inevitable wages of sin.
They were hidden behind a thick veil
of secrecy. A great wall of science
was built up around them. They were
considered unmentionable in mixed
groups, and when discussed at all, they
were talked about in whispers. They
were considered just retribution for
promiscuity instead of serious com-municable
diseases that not only rob
its victims of health and happiness
and even life itself, but endanger oth-ers
in social contact with them.
But the curtain has been raised on
the vast fester of venereal disease
which, like some huge poisonous oc-topus,
has been spreading its infected
tentacles indiscriminately into count-less
thousands of individuals and dis-integrating
the social and economic
fabric of the nation.
Prior to the year 1917 compara-tively
few people had either any idea
of the prevalence of the venereal
diseases or any knowledge of their
disastrous effects. But the importance
of syphilis and gonorrhea in deplet-ing
the manpower of the country
was forcibly brought to public atten-tion
during the World War.
When the first million draftees
were being examined for physical fit-ness
those who were found to be
venereally infected were rejected as
being unfit to assume the burdens
and responsibilities of warfare. The
rate of infection among these men
was so alarmingly high as to startle
the military authorities; and amaz-ing
as it may seem, the number of
men thus rejected was so great that
it was believed impossible for Amer-ica
to raise an army of sufiicient
strength to carry on its part of the
war unless infected men were accept-ed
and made fit to fight. Accordingly,
the men who were returned to civil
life in the first draft call on account
of venereal infection, and those found
to be venereally diseased in subse-quent
draft calls, were inducted into
service, placed in base hospitals, and
10 The Health Bulletin January, 193Jf
treated before they were instructed
in military tactics.
Prior to that time, too, not enough
thought was given to these diseases
to cause any action to be taken to
control them. Very little thought was
given to those persons who innocently
contracted these diseases, and prac-tically
no effort was made to extend
aid to the helpless. And the vast
force of sex, the motivating power of
humanity, the lever for both good
and evil, happiness and misery,
through the medium of which the
venereal diseases are usually trans-mitted,
was almost entirely ignored.
It is indeed tragic that the urge
for happiness and the search for com-panionship
and gaiety should often-times
have such dire results as vene-real
disease, not only to the indi-vidual
alone, but even "unto the third
and fourth generations." The homes
for the feebleminded, the institutions
for the blind and the deaf, and the
hospitals for the insane are harsh
proof of this deplorable fact.
Now, it seems strange that well-informed
men and women are com-monly
quite uninformed concerning
the nature of the extremely danger-ous
and highly prevalent venereal
diseases; and it seems stranger still
that, in many instances, these same
men and women are content to re-main
uninformed on the subject.
Knowledge regarding the venereal
diseases which cause so many dam-aged
lives and which can be so easily
and so innocently contracted should
not be repellant to intelligent minds.
An infected husband or wife may un-wittingly
infect a marital partner.
Through no fault of its own, a baby
may be blinded at birth by gonorrhea,
or may be born dead as a result of
syphilis, or, if it lives, may be so
riddled with the disease as to make
life itself seem a great misfortune.
Little girls frequently contract gon-orrhea
from contact with older per-sons
and from careless nursery at-tention.
And occasionally either dis-ease
is contracted innocently in places
where it is least suspected. All such
persons need protection. As a matter
of fact, these innocent persons are
very apt to suffer more severely in
case they become infected than those
who are familiar with the nature and
effects of syphilis and gonorrhea and
who know that they have been ex-posed
to infection.
Persons who are uninformed con-cerning
syphilis and gonorrhea and
innocently exposed to infection do not
have this protection. Consequently,
such persons may not as a rule seek
early diagnosis and early treatment,
both of which are so necessary to
prevent the disastrous effects of
these diseases when they go untreat-ed,
or when treatment is unduly de-layed.
Nature does not take into consid-eration
the manner in which infec-tion
was contracted. Whether infec-tion
occurs when folly lures or when
the witchery of the season entices;
whether it occurs after known or af-ter
innocent exposure to the disease;
whether it occurs among young girls
or young boys who, when thrown
willy-nilly into the whirlpool of life,
and motivated by one of the most
powerful and subtle forces of nature,
break through the warning signals of
danger; or whether it occurs to the
rich or the poor, the learned or the
ignorant, the saint or the sinner, the
spark is fanned to the flame just the
same.
As long as there are persons with
venereal disease in its infectious
stages, there is an ever potential dan-ger
to all those whose lives they
touch. It must be emphasized, how-ever,
that there is practically no dan-ger
to those persons who refrain
from willful exposure to infection
and who are intelligent enough to
observe good rules of personal hy-giene.
Each normal individual is endowed
with his due share of intelligence and
judgment. Yet in spite of that we
have traffic ordinances with lights on
every corner to guide the motorist
who, if he is able to drive a car,
should be able to guide it success-fully
through traffic. But the law,
like a stern and thoughtful parent,
sees to it that the driver, whether he
be capable or not, follows the lights.
January, 193Jf The Health Bulletin 11
There is no disgrace attached to these
laws, and they are more or less cheer-fully
obeyed. The shunted pariah,
venereal diseases, are far more dan-gerous
than the reckless driver, more
far-reaching than cancer and tuber-culosis,
and more devastating than
both of them combined. Yet many
people are too often prone to ignore
the warning signals of these diseases,
and of which so many people have
been reluctant to talk about openly
and frankly.
There can be only one reasonable
attitude toward the venereal diseases.
They are dangerous and deceptive
communicable infections that should
and must be considered on the same
basis as other infectious diseases.
And they must be stamped out if
man's most precious heritage—good
health—is to be protected and pre-served.
Only by being well informed
on these diseases, and, being well in-formed,
speak about them frankly
and forcefully in the proper circum-stances,
can this be accomplished.
People are more and more adapting
their thought to the conditions of a
changing world. Happily, this is true
also with respect to the venereal dis-eases.
As recent as a decade ago it
would have been considered a breach
of good manners to have mentioned
the venereal diseases in public in the
unadorned terms of syphilis and gon-orrhea.
Since then there has been
an ever increasing tendency to regard
these diseases as serious communica-ble
infections, concerning which the
public is not only constantly seeking
information on measures of preven-tion
and treatment, but, in many in-stances,
is demanding that they be
brought under control.
This emancipation of thought, to-gether
with a constant growing pub-lic
interest in the venereal disease
problem, constitutes one of the great-est
social gains in recent years.
Eating Habits
By Ernest A. Branch, D.D.S., Director Division of Oral Hygiene
YOU remember when you were a
child, your mother was con-stantly
telling you not to touch
the stove. You will also remember
that the warning carried little weight
with it until you learned once and for
all and for yourself just why you
must not touch it, and if touched
what dire and dreadful results fol-lowed.
That is the best way on earth
to learn that fire burns, but costly
—
very costly.
Public Health has a much harder
time of it than a mother, and many
of the evils and dangers against
which it warns are not as sudden as
getting burned. There is one thing
to be said for fire: it burns immedi-ately,
and with one such experience
that lesson is learned for life. With
this as illustration, it is obvious that
Public Health must warn and hope,
and keep on warning and keep on
hoping. With even more children
than the Old Woman Who Lived in
a Shoe, and a great number of them
grown-up children, what is it to do
except to keep after them?
And it must teach them not just
the simple lessons which carry with
them so strong a moral, but must in-struct
them so as to live not merely
longer lives, but more abundant lives,
and teach them how to keep well, and
by keeping well, being happy, in-stead
of dragging around, half-sick
and with a grouch. It must also
teach that the effects of neglecting
health are not so immediate, per-haps,
as the pain of a burn, but are
much more far-reaching and more
crippling in the end.
What if a tooth fell out every
night when you were "too tired to
brush your teeth"? That is drastic,
of course, but if it were true, then
before long there would be so many
horrible examples that we would
soon learn that lesson. It usually
takes so long for neglect to show
that we think we are safe and con-sole
ourselves by saying, "One more
12 The Health Bulletin January, 1934
night won't matter," "I just can't
get Johnny to eat turnip greens and
coUards," "You know, I just have to
force milk down Sally," and "I am
so outdone with little Rachel about
her eating. You know I have reached
the point where I almost hate to go
to the table because we have to beg
and coax Rachel to eat the things
she ought to have, and I do wish you
would tell me how to get her to eat
foods that will make teeth and
bones."
Well, that is just the thing we
want to talk to you about, because if
you could see little Rachel's mouth,
you would find it is literally shot to
pieces so far as teeth are concerned.
She is about five years old, pale, anae-mic,
and does not like to get out
and romp and play with the other
children. Her mother says she is full
of cold nearly all the time; her
breath is bad. Now, if we could get
the entire picture, I suspect we would
find that her mother and dad are just
about as careless in their health hab-its
as little Rachel. The truth of the
whole business is, the mother has
two or three dead teeth in her mouth
and evidences of pyorrhea, and she,
too, is not in the best of physical
health and is a little picayunish about
her eating. Upon questioning, we
find that she and the older mem-bers
of the family were eating at the
table at the same time Rachel was
present, and the older members eat-ing
any and everything they wanted
at any and all times of the day, but
insisted that Rachel must not eat this
or that, but should eat thus and so.
If we expect the child to eat the
proper food, and like it, then we
should adjust our diet to suit this
new condition, and do the same thing
and brag about it and like it, and the
child will follow our example. It is
a mistaken idea that the child does
not notice the difference between our
teaching and our practice.
It has been figured out and we
know just how much calcium and
phosphorus is needed daily for a
growing child, for an adult, and for
the expectant mother. We also know
that there is more available lime (or
calcium) in dairy products than in
other sources, and there is an abun-dance
in green leafy vegetables. Yet,
when the daily ration is evaluated for
minerals, we find that in what is
considered the best regulated of
homes the diet is inadequate in these
tooth- and bone-building materials.
It seems almost like slander to say
that some people use better judgment
in the feeding of their hogs, chickens,
and cows than they do in feeding
their children, and they know more
about "growing mash" for your
chickens and what it should contain
than they do about the necessary
foods to build good teeth. This
should not be, and it is the purpose
of your State Board of Health to
teach the child in our schools a few
of the fundamental things about
foods, food values, and proper health
habits, and to teach oral hygiene
through demonstration. If we can
reach the child and make our teach-ing
acceptable and educationally
sound, we feel confident of eventu-ally
reaching the mother, even
though we have to wait for a new
generation.
This may seem an old story to
some of you, for we have told it so
many, many times. We expect to tell
it again and again, because it is
through repetition that we learn.
Won't you examine your child's
mouth, and if he or she is in need of
dental attention, consult your dentist
immediately? If your children are
not eating foods that supply tooth
and bone-building material, won't
you see that they do? Won't you
look at your mouth and see if you
need dental attention, and if you do,
consult your dentist about your own
mouth? If you are not having the
right kind of food in your diet, it
would be well to look after this also.
The Dental Division of your State
Board of Health is anxious to im-prove
mouth health conditions.
A total of sixteen hundred and fifty-two
North Carolina citizens died of
cancer during the year 1932. The
question now is how many such deaths
may be prevented in 1934.
Jamcary. 193.'f The Health Bulletin 13
North Carolina Turns Over a New Leaf
In Public Health
By M. B. Cheatham
CALL it a New Deal or say that
North Carolina is turning over
a new leaf in public health, or
call it what you will, but at any rate
public health work in the State is mak-ing
the greatest strides it has done
for many a year. The State Board of
Health is pushing a program to use
Federal relief funds for sanitary
projects extending from Murphy to
Manteo. Malarial swamps are being
drained, thousands of privies are be-ing
constructed or repaired, school
and dairy sanitation are being im-proved,
and new water and sewerage
plants are being built in various
parts of the State.
Towns, counties, and individuals
are giving the sanitary program en-thusiastic
cooperation—and rightly
—
because everyone stands to gain and
no one to lose by it. Improved health
conditions will of course benefit the
whole community as well as the indi-vidual
on whose property the im-provement
is made. The individual
or the community is getting neces-sary
or desirable work done at the
cost of only materials and inciden-tals,
with labor and expert supervi-sion
furnished free. The neediest
cases in each community cooperating
will be taken from the relief rolls
and made wage earners, and the
money they make will be spent with
the butcher and the baker, and if no
longer with the candlestick-maker, at
least with every other kind of trades-man
or professional man in the com-munity.
The plan, briefly, is this: The State
Board of Health will furnish from its
own staff trained sanitary engineers
who will supervise the work; labor,
to be recruited as far as possible
from local relief and reemployment
rolls, will be paid for from Federal
relief funds allocated to the C.W.A.,
leaving only the cost of materials and
incidentals to be paid for by the
householder or community. Larger
projects, such as swamp drainage or
the construction of water or sewage
plants, may be financed through the
Public Works Administration, which
makes an outright grant of 30 per
cent of the cost of labor and materi-als,
and loans the balance at 4 per
cent, instead of the usual 6 per cent
interest which such loans usually
carry. By this method of financing
the town saves at the very outset
one-fourth the total cost of the proj-ect
(30 per cent of labor and mate-rial
costs amounting to approximate-ly
25 per cent of the total cost), and
further savings become evident each
year of the amortization period as a
result of the low interest rate
charged. Smaller projects, such as
privy construction, are handled
through Civil Works Administration
assistance providing for the cost of
labor.
The State Board of Health hopes
to carry out malarial control projects
in about thirty counties and privy
construction projects in all the State's
one hundred counties. Work has al-ready
gotten under way in several
counties, and additional counties are
rapidly swinging into line. Figures
tabulated November 15 showed 13
municipal waterworks and sewerage
projects in the State already ap-proved
by the P.W.A., while prelimi-nary
work for 31 additional similar
projects was under way towards get-ting
the applications approved. Other
applications have been made since,
but at the time this issue of The Bul-letin
went to press later figures for
the whole State were not available.
Before beginning privy construc-tion
work on a State-wide scale, the
State Board of Health sanitary engi-neers
made a series of careful experi-ments
to determine the most econom-ical
and at the same time most ef-
14 The Health Bulletin January, 193^
fective method of securing perfection
of details.
In order to use Federal relief funds
on private property, such work must
be shown to be clearly in the public
interest. For this reason cooperation
of all property owners is necessary.
To repair one privy while those
around it are left insanitary would be
of doubtful public value, but to make
all privies in a community sanitary
would obviously be of value to the
community.
For the privy construction work
and the malarial control projects the
State is divided into five main dis-tricts,
with subdivisions of from five
to ten counties each. Each district is
under the supervision of a staff sani-tary
supervisor of the State Board of
Health. Labor is to be recruited lo-cally
from relief or reemployment
rolls. Local supervisors will be, so
far as possible, trained sanitarians
recommended by the local relief ad-ministration
and approved by the
North Carolina Emergency Relief
Administration. The State Board of
Health is not handing out jobs; its
function is the training and super-vising
of local personnel.
The plan of procedure is to organ-ize
work in one community of each
district under a State supervisor, and
as soon as it is in successful opera-tion
to call in other prospective local
supervisors from adjoining counties
for a training course, after which
they will return to their respective
communities to organize work along
similar lines. Local supervisors are
required to hand in daily and weekly
reports of the work done to the State
Board of Health.
P.W.A. loans amounting to more
than two million dollars for sanitary
projects in the State have already
been approved, according to an an-nouncement
released November 2 6 by
Dr. H. G. Baity of Chapel Hill, State
engineer for the P.W.A. Halifax and
Davidson counties and the Waccamaw
district sought loans for drainage
work amounting to $156,234. Loans
totalling close to two million dollars
for water and sewerage plants have
been made to Durham, Granite Falls,
Southern Pines, Siler City, Columbia,
Carolina Beach, Reidsville, Fayette-ville,
Charlotte, Randleman, Frank-lin,
Gibsonville, and Winston-Salem.
Other towns had made applications
which had not been approved at the
time these figures were released.
Amoebic Dysentery
By J. C. Knox, M.D., Asst. Epidemiologist, North Carolina State Board of Health
IN the July issue of The Health
BuiiETiN attention was called to
the dangers of outbreaks of dis-ease
resulting from attendance at the
World's Fair in Chicago. This warn-ing
was specifically against typhoid
fever and smallpox. Recently the
State Board of Health was notified by
the U. S. Public Health Service that
there had occurred in Chicago an
outbreak of amoebic dysentery, result-ing
in 18 5 cases of the disease and 19
deaths, all told, and in the finding of
193 carriers of endamceba histolytica
among the food handlers in that city.
These patients lived in all parts of
the United States and Canada and
are not confined to Chicago or vicin-ity.
The U. S. Public Health Service
also asked that the various boards of
health, both State and local, should
be on the alert for cases of this dis-ease,
especially with the purpose of
locating any case with source of in-fection
traceable to Chicago.
Citizens of this State who visited
the World's Fair should seek medical
advice as early as possible upon the
development of dysentery, even
though mild, for only by thorough
laboratory examinations of a fresh
stool can the accurate diagnosis of
amoebic dysentery be made. There
is a tendency for recurrent attacks,
any of which may be very severe.
CAUSE. Amoebic dysentery is
caused by a unicellular parasite of
the protozoa class; in other words, it
.Ja7iuary, 193.'f The Health Bulletin 15
is a one-celled animal. It is capable
of independent motion by changing
its shape to throw an armlike pro-jection,
pulling itself along in this
manner. This organism has been
found chiefly in the tropical and sub-tropical
areas; however, there is
probably a greater incidence in our
northern climates than we have been
aware of. A few of the physicians in
North Carolina have been finding this
disease in this State for a number of
years, which leads us to believe that
if it were more closely looked for we
would find a greater prevalence in
North Carolina.
SOURCE OF INFECTION. Proba-bly
the greatest source of infection is
from the intestinal discharges from
a carrier of the disease. Unless the
organism is in the encysted or non-motile
form it is not able to cause
the disease in another person. Un-cooked
foods seem to be a great
source of the infection, if handled by
such a carrier. The hands are con-taminated
while at stool and the non-motile
form of the organism is trans-ferred
to the foods that are eaten
raw, while such foods are in the
process of preparation. The disease
is, therefore, chiefly limited to family
outbreaks, especially if the mother
is the carrier. It was determined in
Chicago that the present outbreak
was due to food handlers who were
carriers of the organism. Water may
also be a source of the disease. The
interval between exposure and devel-opment
of symptoms may be a matter
of days or weeks.
PATHOLOGY. In man the large
intestine is the chief site of involve-ment.
The majority of the cases run
a chronic course with intermittent
diarrhea or dysentery of varying in-tensity,
but at any time in such cases
the exacerbation may be very serious.
In the recent outbreak in which
death followed, many of the cases
were undiagnosed, for it simulated
appendicitis or other acute surgical
conditions in the abdomen. Intestinal
hemorrhage or perforation of the
bowel, with a resultant peritonitis
either localized or general, may be
encountered. Abscesses of the liver
occur frequently.
SYMPTOMS. The onset may be
mild or severe. In the acute attacks
the onset is usually sudden, with a
severe pain in the abdomen and a
desire to defecate. Vomiting and nausea
may occur. The diarrhea is serious.
Fifteen to forty stools may occur
within the twenty-four hours, first
with mucus, later containing blood
and shreds of intestinal mucosae.
There is usually very little fever pres-ent.
This condition may clear up af-ter
three or four days and become
more chronic, or any of the above-named
complications may occur.
Many cases are thought to be ap-pendicitis,
due to the intense pain in
the appendiceal area, for the large
bowel at that point is oftentimes
quite extensively involved. There
may be a chronic infection with the
organism and the patient not be
aware of it.
DIAGNOSIS. The diagnosis of the
disease is only made by laboratory
examination of the stool and finding
the amoeba in the motile form; how-ever,
the reports on several of the
cases that have died recently from
the Chicago outbreak show that the
amoeba was not found in the stool
and the diagnosis was made only at
autopsy. A trained eye can pick up
the amoeba very quickly, if present,
but some practice is necessary.
As soon as the diagnosis is made,
active and vigorous treatment should
be instituted by a physician. If the
treatment is begun early, recovery
usually takes place rapidly, even in
the severe attacks.
After recovery has taken place one
should have frequent examinations
of the stool to determine if the
amoeba is present in its encysted
form. One who develops into the
carrier stage is a source of danger to
the immediate family or to anyone
eating food prepared by this individ-ual.
Such a carrier should not be
allowed to engage in the handling or
preparation of foods for public con-sumption.
Personal hygiene is of
paramount importance.
16 The Health Bulletin Jan%ary, IdSJf
Physicians and tlie local health de-partments
should inform the State
Board of Health of all cases of
amoebic dysentery in their immediate
vicinity. If dysentery should occur
in anyone who has recently visited
Chicago, he should consult his physi-cian
for a microscopic examination.
Ignorance More Malignant Than Cancer
CANCER IS CURABLE!
North Carolinians on Saturday
were given assurance of that from
one of the greatest authorities in the
world on the dread malady, Dr. Jo-seph
C. Bloodgood, professor of clini-cal
surgery and director of the Garvin
Experimental Laboratory in Johns
Hopkins University, who spoke at
Wake Forest to 200 physicians and
dentists of North Carolina.
Cancer is curable, but there is an
important condition attached to this
promise. Cancer is curable "if we
could get the correctly informed pa-tient
to the correctly informed and
equipped physician and dentist" in
the early stages of the disease.
In other words, the greatest ob-stacle
to the cure of cancer today is
not the lack of scientific knowledge
as to how to treat the disease, but
the ignorance of the sufferer and the
ignorance of the physician. Granted
the conjunction of an intelligent and
informed patient and an intelligent
and properly equipped physician, can-cer,
if discovered in time, may be
cured, while cancer of the skin, the
mouth, and the cervix may be pre-vented
altogether.
In view of these facts it is a re-markable
commentary upon the State
of North Carolina, where every year
thousands die of cancer, that there is
not, it was stated, one institution
equipped for the treatment of all
kinds of cancer. This in itself is evi-dence
that in North Carolina there is
lacking that informed mind in both
patient and doctor which Dr. Blood-good
makes almost as much a specific
for the cure of cancer as salvarsan is
for syphilis or quinine for malaria.
The North Carolina State Medical
Association is leading in a tremen-dous
work in launching a five-year
cancer control program in this State.
Wisely, too, the association is begin-ning
its program with the education
of the doctors themselves. The more
difficult task of creating an informed
public will follow gradually but
steadily.
North Carolina's problem in fight-ing
cancer, as in many other prob-lems,
is one of ignorance. Cancer is
curable, but it will not be cured until
that even more malignant disease,
ignorance, is wiped out both among
the illiterate and the educated. Some-times
ignorance walks under a col-lege
degree, and occasionally the un-lettered
are less ignorant. In cancer,
as in childbirth, two problems of edu-cation
are of almost equal impor-tance:
insistence upon not only the
qualifying, but also the continuing
education of the doctors, and an
equal insistence upon the necessarily
more gradual education of the people
in matters of personal as well as pub-lic
health.
—
l<!ews and Observer.
SUGGESTED NEW YEAR
RESOLUTIONS
By M. B. C.
Things which can be done once and
for all and not hang over you for the
other 364 days in the year:
1. To have my child vaccinated
against typhoid fever, diphtheria, and
smallpox immediately.
2. To have my child given a thor-ough
physical examination by a com-petent
physician, and to have any de-fects
of eyes, teeth, tonsils, etc., cor-rected
immediately.
3. To have myself given a thorough
physical examination if I have not
had one in the past year, and to have
all defects corrected.
4. To write today to the State
Board of Health for that free litera-ture
which you need and which you
have been putting off writing for.
\
ifl
Putli5\edbM TAZ./4°RJ/iCAR9LU^A STATE. E)^ARDs^AEMJ/\
This DuJleliAwillbe 5er\t free to arwj citizeA of the State \jpor\ request, j
Entered aa second-class matter at Po9toffi.ce at Raleigh, N. C, under Act of July 16, 189U
Published monthly at the office of the Secretary of the Board, Raleigh, N. C.
Vol. XLIX FEBRUARY, 1934 No. 2
Home of the North Carolina State Board of Health
Readers of THE BULLETIN are again in^-ited to visit the offices of the
State Board of Healtli at any time while in Raleigh. School teachers accom-panying
children to Raleigh should include the Health Department in their
list of places to be visited.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OP HEALTH
Cajo. V. Reynolds, M.D., President Asheville
G. G. Dixon, M.D Ayden
S. D. Craig, M.D Winston-Salem
H. Lee Large, M.D Rocky Mount
J. N. Johnson, D.D.S Goldsboro
H. G. Baity, Sc.D Chapel Hill
W. T. Rainey, M.D Fayetteville
Hubert B. Haywood, M.D Raleigh
James P. Stowe, Ph.G Charlotte
Executive Staff
James M. Parrott, M.D., Secretary and State Health Officer.
G. M. CooPEE, M D., Director Division of Preventive Medicine.
Warren H. Booker, C.E., Director Division of Sanitary Engineering.
Ernest A. Branch, D.D.S., Director Division of Oral Hygiene.
John H. Hamilton, M.D., Director Division of Laboratories
and Vital Statistics,
M. V. ZlEGLER, M.D., Acting Director Division of County
Health Work.
D. F. Milam, M.D., Acting Epidemiologist.
FREE HEALTH LITERATURE
The State Board of Health publishes monthly The Health Bulletin
which will be sent free to any citizen requesting it. The Board also has
available for distribution without charge special literature on the follow-ing
subjects. Ask for any in which you may be interested.
Adenoids and Tonsils
Cancer
Constipation
Chickenpox
Diabetes
Diphtheria
Don't Spit Placard*
Eyes
Flies
Fly Placards
German Measles
Health Education
Hookworm Disease
Infantile Paralysis
Influenza
Malaria
Measles
Pellagra
Residential Sewage
Disposal Plants
Sanitary Privies
Scarlet Fever
Smallpox
Teeth
Tuberculosis
Tuberculosis Placards
Typhoid Fever
Typhoid Placards
Venereal Diseases
Water Supplies
Whooping Cough
SPECIAL LITERATURE ON MATERNITY AND INFANCY
The following special literature on the subjects listed below will be sent
free to any citizen of the State on request to the State Board of Health,
Raleigh, N. C.
Prenatal Care (by Mrs. Max West)
"Our Babies"
Prenatal Letters (series of nine
monthly letters)
Minimum Standards of Prenatal Care
Breast Feeding
Infant Care. The Prevention of
Infantile Diarrhea
Table of Heights and Weights
Baby's Daily Time Cards : Under 5 months
;
5 to 6 months ; 7, 8, and 9 months ; 10,
11, and 12 months; 1 year to 19 months;
19 months to 2 years.
Diet List: 9 to 12 months: 12 to 15
months ; 15 to 24 months ; 2 to 3
years ; 3 to 6 years.
Instructions for North Carolina Midwives.
CONTENTS
PAGE
Notes and Comment ^
"Damaged Lives" : A New Motion Picture 5
Pure Food and Drugs 6
Deaths in 1933 '^
"Sunshine" °
A Baby Flies From Texas to Baltimore .'- 9
First Aid to Save Life: Organized Common Sense 10
"They Say" 14
Measles ^°
Description of a Case of Hookworm in Georgia in 1840 16
Vol. XLIX FEBRUARY, 1934 No. 2
Notes and Comment
THE month of February has two
points of significant interest for
at least two classes of people of
North Carolina. One is Saint Valen-tine's
Day, which interests the young
folks; the other is Garden Planting
Month, which is a responsibility of the
householders of the rural districts of
the State, or certainly for the south-ern
half of the State. The old-time
farmer and gardener of North Carolina
looked upon any neighbor who failed
to begin his garden planting in the
month of February as not living up to
the traditions of a tiller of the soil.
For our State it is very probable that
in no year since 1865 has it been more
important for the people to begin early
and to continue every day throughout
the year to plan and cultivate just as
many of the food crops as it is possible
to raise. The cultivation should be
thorough and intensive and should
cover every available plat in the State
capable of producing vegetables and
other food crops. The expenditures of
the National Government at the rate
it has been going for the last few
months cannot continue forever. Pros-perity
may be here by December, no-body
may be without a job, cotton and
tobacco may sell at a high price, the
crops may be bountiful; if so, no harm
will have been done. On the other
hand, jobs may be harder to secure
than ever before, money may be
scarcer, cash crops may sell for less;
but food which is raised and saved will
be capable of saving life and prevent-ing
hunger for all the population.
Such diseases as pellagra and such
conditions as malnutrition among
children can be entirely prevented by
proper attention to the production and
distribution of the food crops which
can be raised anywhere in this State.
From the standpoint of health, hap-piness,
and prosperity nothing could
be more important than attention to
this matter by all our people.
4c ^ Hi
SOMETIME ago Senator J. W. Bai-ley
had a very interesting article
in some of the daily papers under the
general title of "What Is the Matter
With North Carolina?" In the course
of his article Senator Bailey men-tioned
the fact that North Carolina
could easily care for a population of
five million or more, provided the in-dustrial
and agricultural population
were properly balanced and foreign
markets for surplus products developed
so as to assure a productive occupa-tion
for every individual constituting
such a population.
On the same date in which Senator
Bailey's article appeared in the papers
a dispatch from Japan was published
in one of the New York papers. The
Japanese article was confined largely
to a discussion of the rapidly increas-ing
population of Japan, the rate of
increase being placed at between 400,-
000 and 500,000 a year. In fact, last
year the increase was more than a mil-lion.
The population of that country
on October 1 was placed at more than
66.000,000.
The average Japanese farm is 2.7
acres in extent and supports an aver-age
family of six people. The state-ment
was made that Japan is more
crowded than any other country in the
world, being nearly three times as
thickly populated as Belgium. The
reader can understand something of
The Health Bulletin February, 1934
the crowded condition by comparing
tlie country of Japan witli tlie State of
California, wliich has only five and a
half million people. But California
has twice the land area of Japan.
They have an Oriental birth rate of
nearly 33 per 1,000 live births, which
is a great deal higher than the Ameri-can
birth rate, and almost twice as
high as the European birth rate. Ja-pan,
it will be noted, has a death rate
nearly as low as the United States. It
is said that the birth rate in Japan is
falling a little, due to the fact that
marriages are fewer and that their ris-ing
standard of living means later
marriages.
The writer in the New York paper
goes on to explain that, so far, the Jap-anese
have dealt with this problem
successfully by extending their eco-nomic
frontier. Their cheap goods
have found markets abroad by under-selling
any other country. The writer
states that the Japanese are disci-plined,
but not a docile people. Ninety-seven
per cent of them can read and
write, and they are great readers. It
is said that the number of students at
technical schools and colleges is enor-mous.
In an article in The Health Bul-letin
more than fifteen years ago we
pointed out that Japan was one of the
first countries in the world, following
Germany, to institute a complete sys-tem
of medical inspection of all school
children. Corrective treatment and
preventive measures have followed
throughout all this period. For almost
fifty years they have kept up their
scientific methods of preventing dis-ease
and of rearing a healthy popula-tion.
It is probable that no country
in the world is any nearer physical
perfection than the Japanese. Their
scientists rank with the best of the
world. Having an imperialistic, cen-tralized
government, they are in a po-sition
to enforce to the last letter
their nationalistic program. The em-phasis
has been placed on physical per-fection
and literary excellence. It is
doubtful that any other country in the
world can successfully claim 97 per
cent of the population to be able to
read and write.
When we compare our own sporadic
methods of medical inspection of
schools, our own neglect of the physi-cal
and mental development of the
masses of our people, and the methods
followed in Japan, we cannot help but
wonder at the tremendous significance
of that country in the world affairs to-day.
If we could only put a little of
our excess energy and surplus money
into a comprehensive system of organ-ized
health activity with disease pre-vention
and the promotion of physical
and mental health for every child in
the remote sections of this State, it
would not be long before North Caro-lina
could compare favorably with Ja-pan
in this respect. J
IN a recent issue of the Neio York
Times, under the general subject of
"The Week in Science," written by
Waldemar Kaempffert, appears an in-teresting
article from Italy. This ar-ticle
may be of considerable interest to
some of our people who have to deal
with the mosquito problem for several
months in the year. In reading the
item describing the experiment in It-aly,
it should be borne in mind that
the people in most European coun-tries
live in much closer contact with
their animals than do our people. Mul-titudes
of families in countries of Eu-rope
occupy the second floor of their
home, and their pigs and cattle and
poultry and so on are housed on the
first floor, directly underneath the
family quarters.
If animals, such as hogs, are to di-vert
the attacks of mosquitoes from
members of the family in heavily in-fested
areas, it is evident that the ani-mals
must be very close to the house,
which might or might not be for the
best interest of the general health of
the household. If thorough screening
and other methods of protection
against mosquitoes can be carried out
at all times, we should much prefer to
have the animals' quarters a long dis-tance
from the house. In procuring
protection from mosquitoes, the house-fly
pest might be increased, and there-fore
one evil would be exchanged for
another. Another consideration is
February. 193.i The Health Bulletin
that mosquitoes in Italy are in some
instances of a different type from the
mosquitoes in eastern North Carolina.
The article, however, is very interest-ing,
and we quote as follows:
PIGS DECOY MOSQUITOES
An Exjjeriment That Reduced
the Numb67^ of Malaria
Cases
Amid the Etruscan ruins of Ardea
lies a little Italian village with a pop-ulation
of 513. Mosquitoes of the
malaria-bearing Anopheles variety
swarmed there. Despite all preventive
measures the cases of malaria rose
from 23.6 per cent in 1929 to 46.9 in
1930 and fell to 32.6 in 1931.
When the public health authorities
inspected the village in 1931 they gave
orders to install twenty hog-pens. Be-fore
that there had been only two, be-sides
three stables for cattle. The ef-fect
was almost miraculous.
Dr. Escalar, who saved the village
fi'om much scratching and illness,
states that the number of Anopheles
mosquitoes in houses dropped 60
per cent in 1932. He caught 139
Anopheles gorged with blood, but the
blood of 97 was hog blood. Not one
of the rest contained human blood.
Between May and December, 1931,
there were 87 cases of malaria in Ar-dea,
but in the same period of 1932
only 38. The cases of malaria dropped
from 46.7 per cent in 1930 to 32.6 in
1931, and to 8.94 in 1932, after the
hog-pens were installed.
^ Damaged Lives': A New Motion Picture
By EvART G. RouTzAN, in Journal of American Public Health Association
DAMAGED LIVES: A New Mo-tion
Picture. The new pic-ture
was introduced to public
health workers during the A. P. H. A.
meeting in Indianapolis. Says JoitrrMl
of Social Hygiene:
After careful consideration, and
study of opinions received from sev-eral
hundred physicians, health and
governmental oflBcials, social workers,
nurses, and representatives of re-ligious,
educational, and other organi-zations,
the executive committee of
the American Social Hygiene Associa-tion
has agreed to endorse the motion-picture
drama, "Damaged Lives," re-cently
produced by Weldon Pictures
Corporation and dealing with the sub-ject
of syphilis. The film, with a sup-plementary
medical lecture film, is ex-pected
to be shown in selected repre-sentative
theatres throughout the
United States, the premier showing be-ing
at the Majestic Theatre in Boston,
on September 15, with the cooperation
of the Massachusetts Society for Social
Hygiene, the Massachusetts State De-partment
of Health, and other state
and city agencies.
This represents the first union of
forces between recognized health agen-cies
and commercial producers in the
United States in an attempt to com-bine
the technic of sound motion-pic-ture
photography with authoritative
health information for showings in
commercial motion-picture theatres
for paid admissions. In the opinion of
competent medical and educational au-thorities,
this union will have far-reaching
and important results in
adult mass education.
The production is the culmination
of five years of study by motion-picture
producers, in cooperation particularly
with the Canadian Social Hygiene
Council and with the American Social
Hygiene Association, regarding prepa-ration
of a modern talking-picture
drama which might be a worthy suc-cessor
to Brieux's "Damaged Goods,"
produced twenty years ago on stage
and screen, and the association's silent
drama films, "The End of the Road,"
which was shown throughout the
United States shortly after the World
War in connection with the Govern-ment's
campaign against venereal dis-eases.
Competent critics of all three
productions consider "Damaged Lives"
by far the most potentially effective in
its educational possibilities. It is an
appealing human story, produced with
extraordinary good taste, is well cast,
well acted, and well photographed.
The first public showing in the
United States, held in Boston, was pre-sided
over by the State Commissioner
of Health, with speakers representing
the Boston Health Department, the
The Health Bulletin February, 193^
dramatic editors of the city, and other
groups. There was a distinguished
group of patrons and patronesses. It
would seem that other cities might
make a significant event of the local
showing of the picture. See Journal
of Social Hygiene for additional infor-mation,
and address inquiries to
American Social Hygiene Association,
450 Seventh Avenue, New York.
Pure Food and Drugs
IN its issue of December 20 the
Biblical Recorder published an ed-itorial
in support of the bill now
before Congress designed to correct
some of the evils existing in the food,
drug, and cosmetic trade in the United
States. The Biblical Recorder is the
organ of the Baptist Church in North
Carolina. It is one of the ablest edited
church papers in the country, and it is
pleasing to the editors of The Health
BuLXETiN to see such papers repre-senting
the religious press take an
open stand opposing the abuses now
carried on in trade circles exploiting
the people in numerous ways.
Some thirty years ago, when the so-called
patent medicine industry be-came
such a stench in the nostrils of
decent people throughout the country
that there occurred a popular upris-ing
against the methods then prac-ticed,
one of the serious obstacles was
the advertising columns of the church
papers. With very few exceptions the
religious journals of that period held
their advertising columns just as wide
open to the advertisements of patent
medicine nostrums as did the secular
press. It is pleasing today to record
the fact that very few, if any, religious
papers in the country of reputable
standing carry such advertising at all.
The Tugwell Bill, which will prob-ably
be amended so that its friends
will scarcely recognize it before it
passes Congress, or, what is more prob-able,
a substitute bill will take its
place which will be agreeable to the
manufacturers and the national adver-tising
agencies living off the food,
drug, and cosmetic trade, is an at-tempt
to eliminate the more abusive
practices which now exist. One of
the chief features is what is known as
the Open Formula; that is, the require-ment
that the formula of each adver-tised
product shall appear on the label,
on the package, and in the advertising
matter. It is a question of simple
honesty. It provides that the pur-chaser
may know what he is buying.
The very fact that this feature is so
bitterly assailed is the greater evi- ,
dence that it meets the issue squarely, |
If the purchaser of any food, drug, or
cosmetic knows exactly what he Is
buying, there is no mystery about the
transaction, and any product must
stand or fall on its merits. Could
anything be fairer?
If the product has merit and is sold
at a reasonable price, it should and
could be advertised all over the earth,
and its success could and would be as-sured.
The answer comes back that
competitors would undersell. In these
days of codes and trade regulations
this is not probable. The same accusa-tion
could be brought against the man-ufacturers
of automobiles. The pur-chaser
of an automobile knows defi-nitely
what he is buying. The manu-facturers
advertise the facts to the
world, and yet there is no lack of a
supply of desirable cars and no lack of
automobile manufacturers in the mil-lionaire
class.
A simple example of this fact may
be noted by any resident, at least of
Raleigh or Greensboro, and probably
other towns in the State. For sev-eral
months the purveyors of a sim-ple
saline have been renting a sep-arate
store in Raleigh and one in
Greensboro, and with attractive adver-tising
matter and a catchy name have
been pulling in suckers at an amazing
rate. The specialty in this line is a
bottle of stuff which sells for $1.50.
The chief ingredient which the pro-ducers
would be compelled to put on
the bottle label if the Tugwell Bill were
to pass consists of about 5 cents worth
February, 193^ The Health Bulletin
of Glauber's salt. There Is a trace of
Epsom salts, which is still cheaper;
and also a trace of common old table
salt, which may be bought for still
less. Altogether the cost of the prod-uct,
including bottle and label and
stopper and package, could not pos-sibly
be more than 10 cents. Yet the
sucker is led to pay his $1.50 in good
money for this concoction, which few
of them would do if they knew they
were simply buying 5 cents worth of
Glauber's salt for $1.50.
If it were not for the mystery con-cerning
most of these products and
emphasized in the advertising matter,
the whole trade would fall flat. The
profit made from the manufacture and
sale of questionable products, either of
food, drugs, or cosmetics, does not go
altogether to the wholesale and retail
dealers nor to the manufacturers, but
it goes to the national advertising
agencies and the newspapers of the
country who carry such advertising.
In other words, the sole power in-herent
in such a product is not con-tained
in the products themselves, but
in the advertising attractions. Suck-ers
can be hooked through an attrac-tive
advertisement who could not be
reached in any other way. The suc-cess
of the patent medicine business
—
its continued success—is a standing
testimonial to the value of printers'
ink in the form of attractive advertis-ing.
The editor of the Biblical Recorder
concludes his editorial with the fol-lowing
pertinent sentences:
"Patent medicine manufacturers are
heavy advertisers and hope to bring
pressure to bear on the periodicals in
which they have been carrying adver-tisements.
But the probabilities are
that the new bill will be drastic enough
and will be enacted into law. It is
promoted by Assistant Secretary of
Agriculture Tugwell, who has made
speeches over the radio in support of
it. We need a law that will prevent
the abuses of which Mr. Tugwell has
been telling over the radio and of
which Mr. Mitchell has written."
In an editorial appearing in the Ra-leigh
Neics and Observer of December
30, under the heading "Guard the In-ner
Man," the editor says:
"No other legislation before the Con-gress
which convenes next week will
be so important to Mr. and Mrs. John
Citizen and the little Citizens in their
private lives as that which will under-take
to bring the regulation of food
and drugs up to date. . . .
"One of the best features of all the
proposed legislation is that which will
require a new and greater responsibil-ity
for misleading advertisements of
foods or drugs. If advertising has the
virtue which its venders claim for it
—
and the available evidence indicates
that it has—then a misleading adver-tisement
in a newspaper, magazine, or
radio broadcast is far more dangerous
to the public than a misleading label
on a box or a bottle."
In the second paragraph just quoted
from The News and Observer the edi-tor
emphasized in a few words the
evils we have been trying to point out
in this article. In short, a misleading
advertisement, as the editor of The
Neics and Observer states, is far more
dangerous to the public than even a
misleading label on the package or on
the bottle.
DEATHS IN 1933
Typhoid Deaths Fewer, But More
Diphtheria Deaths
We are pleased to announce that the
provisional reports of deaths occurring
in North Carolina for 1933 record
fewer deaths from typhoid fever than
in any year in the history of the State.
There has also been no death from
smallpox in this State in two years.
This is another remarkable record.
Both diseases are preventable, and this
record indicates that preventive agen-cies
have been alert. In other re-spects,
the picture is less encouraging.
There was a slight increase in deaths
of babies under two years of age
caused by diarrhea and enteritis, al-though
the general death rate for in-fants
under one year wull probably be
no higher than in 1932. There was an
increase in the deaths from puerperal
septicemia, and, finally, there was an
increase in deaths from diphtheria. It
is well to record here that the usual
activities in immunizing against diph-theria
were not carried out in 1933 by
the State Board of Health because of a
lack of funds.
8 The Health Bulletin February, 193If I
"Sunshine"
By J. C. Knox, M.D.
RECENTLY several newspapers
have been calling our attention
to the lack of availability of
electric power to the masses of people
in rural communities. This power is
considered one of our natural re-sources
which belongs primarily to
the citizens of the State, and as such
should be readily available to all of
its inhabitants. It is hoped that
through this agitation electricity will
soon find its way to those communi-ties
and at such rates as not to pro-hibit
its use. "Back to the farm"
movement will receive added impetus
if the rural homes can be provided
with the luxuries that come with use
of electricity. There are other natural
resources that should be protected and
set aside for use of the people of the
State. State-owned, protected, and su-pervised
forests located in the various
typical geological divisions of the State
should receive serious consideration.
Also, these areas could serve as game
refuges. The necessity for protection
of native wild animal life will eventu-ally
force itself upon us.
The toast often given to North Caro-lina
is:
"Here's to the land of the long-leaf
pine.
The summer land, where the sun
doth shine;
Where the weak groio strong, and the
strong grow great—
Here's to 'down home,' the Old
North State."
This toast brings to mind another
great resource which necessitates no
expenditure of money for bringing it to
each individual in sufficient quanti-ties
to be of great value. Sunshine
—
we have it with us much of the time.
There is no need for newspapers to
espouse its conservation. Greater use
of sunshine by the people of the State
is a thing to be desired, for there are
properties in the various rays that are
of considerable benefit to man. The
deficiency disease, rickets, is quite
commonly found in this State among
the infants and young children. There
is a failure of proper utilization of the
mineral calcium, which may or may
not be present in sufficient quantities
in the child's diet. If calcium is pres-ent
in the food in adequate amounts
there is a faulty mechanism in deposi-tion
of these salts in the bones. They
fail to harden as they should, thereby
resulting in unsightly deformities,
such as bowed legs, odd shaped heads,
and sometimes crooked chests and
spines. Of course, if the necessary cal-cium
is absent from the diet, then the
results are the same as above stated.
Cod-liver oil is given for this condi-tion,
and when it is administered in
proper amounts, when the diet con-tains
the necessary calcium, the con-dition
is cured. An adequate diet
given in conjunction with suitable
amounts of cod-liver oil prevents rick-ets
from developing. Ultra-violet
rays, either artificial or natural, such
as found in sunlight, are beneficial in
aiding either the prevention or cure of
rickets. Unfiltered sunlight in direct
contact with the body exerts its bene-ficial
effects. Ordinary windowpanes
act as filters to the ultra-violet rays.
Special glass or screens which allow
these rays to pass through have not
turned out to be of much practical
value. Smoky or dust-laden atmos-phere
also acts as a filter for sunshine.
Sunshine is of less value in winter.
Exposure to its rays at this time
should be between the hours of 10
a.m. and 3 p.m. In summer, exposure
to sunshine may cause blistering of
the skin. Caution should be exercised
when exposing infants to summer rays.
Avoid exposure during the middle of
the day; before 9 a.m. and after 4 p.m.
is usually sufficient.
Sunlight is also beneficial in the pre-vention
and cure of tuberculosis. Sun-light
has a very decided germicidal
power. Few disease-producing germs
can resist the exposure to direct sun-light
for any length of time. Our care-ful
attention should be given to a more
general use of the many natural re-sources
within our borders.
February, 193^ The Health Bulletin
A Baby Flies From Texas To Baltimore
ADAY or two after Christmas all
the world was thrilled by news-
*" paper headlines describing the
flight of a famous aviator from Hous-ton,
Texas, to Baltimore. His trip
was made mostly at night, landing on
a snow-covered field at 2 o'clock in
the morning. The trip was a danger-ous
one, made not only at night, but
in the face of a very cold wind. The
trip was a sensational one because
his chief passenger was a five-months-old
baby girl being taken to a Balti-more
doctor for a brain operation.
The baby's parents, nurse, an uncle,
and even a grandmother, all went
along. Could any baby's adventure
be more spectacular? A fourteen-hundred-
mile trip with its family at
night in stormy weather to consult a
doctor in Baltimore! The parents and
the aviator thought they were in a
race with death, and they probably
were. It is earnestly hoped that the
treatment provided by the Baltimore
specialist saved the life of the baby
and that she will grow up to happy
womanhood and be a joy to her par-ents
forever.
The writer of these lines would
not minimize the importance of the
trip of the Texas baby. On the other
hand, the love of the parents, the
courage and ability of the pilot of the
airplane, and the quiet skill of the
physician, skill obtained through long
years of work and study, all should
be awarded the highest praise and
admiration. But the writer has been
for many long years troubled about
the loss of thousands of lives of
babies in North Carolina, a very large
percentage of which could very easily
have been prevented. These infant
deaths might nearly all be prevented
without the necessity of long trips in
airplanes to distant specialists. So,
on reading the headlines about the
strenuous efforts to save the life of
the Texas baby, the writer's mind
instantly visualized the situation in
North Carolina.
During the first eleven months of
1933 a total of 4,539 infants under
one year of age died in our State. The
newspapers reported that it took
about eleven hours for the airplane
to travel from Houston to Baltimore.
At the rate our babies were dying in
the first eleven months, about six
North Carolina babies of the same
tender age as the little Texas passen-ger
died during the eleven hours the
plane was traveling from Texas to
Baltimore. At least five of our babies
could have been saved if their parents
had made use of the knowledge avail-able
now to every parent about the
care and protection of babies. The
great killers of our babies—faulty
feeding habits, infectious and com-municable
diseases—could all be pre-vented.
A postal card to the State
Board of Health at Raleigh has
brought information to the mother
of many a baby during the last few
years which has enabled her to better
protect her babies. Many little lives
have been saved who would other-wise
have perished. Their homes are
scattered all over the remote sections
of this rural State all the way from
Knott's Island to Culberson. Most of
them live miles from the nearest
physician.
The prevention of infant deaths re-quires
primarily two things on the
part of the babies' parents: First,
information; second, the determina-tion
to intelligently apply that infor-mation
in the care of their baby. In
theory simple enough. In practice
diflacult because it requires self-de-nial,
industry, and intelligence, attri-butes
all parents do not yet possess.
Information on infant care is avail-able
free of charge to every mother
in North Carolina who will spend a
penny for a postal card and take the
trouble to write to the State Board
of Health for it.
10 The Health Bulletin February, 1934
Fir^ Aid To Save Life
:
Organized Common Sense
By Mary Cheatham
TO die or not to die often de-pends
on a knowledge of first
aid. An accident happens—
a
cut artery; a child swallows poison;
a gas jet leaks—asphyxiation; or a
swimmer goes under the third time.
A delay of even a few moments
means death. Such occurrences are
common, but how many people know
what to do to prevent death during
that fatal interval until the doctor
comes? Do you, or you, or you? The
life of a loved one may depend on
your knowledge.
The ironic thing about first aid is
that we need it when we least expect
to, and when the accident happens we
have neither the time nor the means
available to sit down then and study
what to do. Everyone should take
the responsibility of learning at least
those fundamental principles of first
aid on which life itself may depend.
First aid is not at all hard to learn;
in fact, it is largely a matter of or-ganized
common sense. If the patient
has stopped breathing, you make him
breathe; if he is bleeding dangerous-ly,
you check the bleeding; If he has
swallowed poison, you get it out of
his system. It sounds simple, and is
simple, but would you think of it in
the emergency unless your attention
had been called to it in calmer mo-ments?
Certain general rules should be fol-lowed
in all accidents. The first rule
in any emergency is to keep your
head and keep calm. Nothing is ever
so bad but panic makes it worse.
To assure keeping your head, the
best way is to know in advance ex-actly
what to do in such a situation.
Keep the patient calm, and keep the
crowd back so the patient can get air.
Call the doctor at once if the injury
is at all serious, but do not wait for
him to arrive. Observe absolute clean-liness
both in your own hands and in
all dressing used on open wounds.
Remember that a dirty or unsterilized
dressing may be worse than none. In
the treatment itself, notice first
breathing, severe bleeding and shock,
all to be discussed below. Let every-thing
else go until breathing is re-established
and severe bleeding
checked. If the injury is at all seri- 1
ous always have the patient lie down; *
if face is flushed, raise head slightly;
if pale, lower head. If there is vom-iting,
turn the head to one side.
Loosen any tight clothing such as cor-sets
and collars, which may interfere
with breathing. Make the patient as
comfortable as possible with as little
movement of the injured part as pos-sible.
To get at the injured part, if
necessary cut clothing rather than
move injured part in removing cloth-ing.
As a secondary consideration
save the clothing as much as possible
by cutting up seams where practical.
If the patient must be moved, if the
injury is at all serious, move him
lying down. Improvised stretchers
can be made by running poles
through grain sacks, skirts, buttoning
coats over poles, or using doors or
gates. If you have no poles, roll the
edges of skirts or blankets tightly to
make a firm edge for carrying.
The use and abuse of stimulants
should also be clearly understood,
and is again largely a matter of com-mon
sense. Give stimulants when the
patient is faint and when heart action
needs stimulation. Never give the
patient stimulants to swallow until
he is conscious, or you will strangle
him. Never give stimulants when the
head has been injured, when the
bleeding is profuse, or when the face
is flushed and the pulse strong. The
best common stimulants are hot black
coffee and aromatic spirits of ammo-nia.
Alcohol is not a good stimulant
February, 1934 The Health Bulletin 11
because in the end it produces de-pression
rather than stimulation.
Poison
But enough of theorizing; now for
specific cases. Poisoning is one of the
commonest accidents requiring im-mediate
action to save life. In this
more than in almost any class of acci-dent,
prevention is the best treat-ment.
Do not keep poisons around
the house unless absolutely necessary,
and never, never leave them in reach
of children. If you must have poisons
in the home, have them clearly
marked both to the eye and to touch.
A good plan is to have adhesive tape,
rubber bands, or other easily detected
substances on the outside of the bot-tle
and have it clearly labeled
POISON. Never take medicines in
the dark or without examining the
bottle and knowing exactly what is
in it.
But if in spite of all precautions
someone still takes poison, act im-mediately.
Call the doctor at once,
telling him what poison has been
taken, so that he can bring the proper
antidote; but do not wait for him to
come. Give the patient mucilaginous
drinks, such as milk, raw eggs, salad
oil, etc., to check the absorption of
the poison into the body. Unless the
patient's lips are burned by acid, give
an emetic immediately to cause vom-iting.
Soapsuds, salt, mustard, or
baking soda in lukewarm water are
usually effective; but if they fail to
cause vomiting, tickle the back of the
patient's throat. Repeat, washing out
the patient's stomach with several
glasses of lukewarm water with soap-suds,
soda, etc., until the stomach is
completely emptied. Give a large
dose of Epsom salts, and if the symp-toms
are present, treat for shock (de-scribed
below). In carbolic-acid poi-soning
use soapsuds, or Epsom salts in
water, to cause vomiting. If delirium
threatens, dash cold water on the pa-tient's
face and head.
Shock
In treatment of poison and many
other injuries one must frequently
treat for shock, also. Shock, medi-cally
speaking, is a condition in
which all activities of the body are
greatly depressed, resulting from in-jury
or intense emotion. Symptoms
of shock are cold, clammy skin, weak,
rapid pulse, irregular or gasping
breath, subnormal temperature. The
patient may or may not be uncon-scious,
but he appears stupid and
dazed. Treatment for shock is rest,
heat, and stimulants. Have the pa-tient
flat on his back with head low,
cover warmly with blankets, and use
hot-water bottles, being particularly
careful not to burn him, as he is more
easily burned at this time. When he
is conscious, and if there is no bleed-ing,
give stimulant. Call doctor if
serious. _ ., ,. Resuscitation
Another very common class of acci-dents
in which immediate action is
necessary to save life are those in
which the patient has stopped breath-ing.
Always make reestablishing
breathing the first consideration in
such accidents. The Schaefer prone
pressure method is usually considered
the best method of artificial respira-tion,
because it requires no equip-ment
and one operator can do it for
a long period of time without as-sistance.
Remember every moment is
precious. Remove any gum, tobacco,
etc., from the patient's mouth and
proceed as follows:
1. Lay patient flat on his stomach
with arms extended overhead and
bent at the elbow, with face turned
outward. See that the nose and mouth
are free for breathing.
2. Kneel, straddling the patient's
thighs and facing his head. Place
palms of hands on small of patient's
back with fingers resting on ribs, lit-tle
finger just touching the lowest
rib.
3. With arms rigid swing slowly
forward until the shoulders are di-rectly
over the heel of the hands
with weight of the body on the wrists,
making firm, steady pressure on the
patient. Do not bend elbows. Hold
the pressure while counting one, two,
three. This forces the air out of the
lungs.
4. Now snatch hands away quickly
and swing back, removing pressure
12 The Health Bulletin Feb7-uary, 1934
completely while you count one, two.
With the releasing of pressure the
chest expands and draws in air.
5. Repeat, alternating pressure and
release at the rate of about twelve or
fifteen times a minute, the complete
double movement taking about four
or five seconds, approximately the
normal rate of breathing.
6. Continue artificial respiration
without interruption until the patient
resumes normal breathing or until
the doctor pronounces him dead. It
may be necessary to work for four
hours or longer.
7. If a second person is present,
have him loosen patient's clothing,
cover him warmly, and rub arms and
legs to help circulation, but do not
let this interfere with respiration.
Keep the patient warm.
8. To avoid strain of the heart,
keep the patient lying down even af-ter
he revives. When he is conscious,
not before, give stimulants.
9. If possible do not move patient
until he is breathing; but if he must
be moved, continue respiration dur-ing
the moving. If it is necessary to
change operators, do it without
breaking the rhythm of the breath-ing.
10. A brief recovery may be fol-lowed
by a sudden lapse of breathing.
So keep watch on the patient even
after he is considered out of danger,
and at the first sign of stopping
breathing resume efforts again.
Gas Poisoning
Artificial respiration is necessary in
drowning, gas poisoning, electric
shock, strangulation, etc. Gas poison-ing
may result from leaking gas fix-tures,
poorly regulated gas or coal
stoves, running automobile engine in
closed garage, and other causes. In
gas rescue, remove patient to fresh
air immediately, send for the doctor,
and give artificial respiration. Gas is
lighter than air; therefore the air
nearest the floor is purest. To rescue
patient from gas-filled room, tie his
hands together with a handkerchief,
slip his arms around your neck, and
crawl out on all-fours, dragging his
unconscious body under your own.
Electric Shock
In electric shock the patient
touches a live electric wire. Release
patient from wire at once; he cannot
release himself. Give artificial respi-ration,
send for the doctor, treat
burns, and if necessary treat for
shock. In rescuing patient from wire
remember that the body is a conduc-tor,
and touching the patient is like
touching the wire itself. If the cur-rent
cannot be shut off at once, be-fore
attempting rescue insulate your-self
by wrapping your hands with
several thicknesses of cloth, rubber,
newspapers, etc., or by standing on
dry boards, glass, rubber, or dry
clothes. They must be dry, as any-thing
wet acts as a conductor, and if
you are not careful you will have to
be rescued yourself.
Hemorrhage
Wounds with serious bleeding al-ways
require immediate action. How
often have you read accounts where
the patient bled to death before help
arrived? Perhaps you think such ac-cidents
are too rare for you to bother
learning about them. I thought so
too, once—until my ninety-year-old
grandmother, in her room sewing,
apparently as harmless an occupation
as you could wish, reached into her
workbasket and accidentally stuck
the scissors into her wrist, punctur-ing
the principal artery there. She
would have bled to death in a very
few minutes if my brother had not
known how to apply a tourniquet,
using a handkerchief and a wooden
golf tee in his pocket.
In all wounds there is the double
danger of infection and hemorrhage
or serious bleeding, either of which
may be fatal. Serious bleeding should
always be checked before anything
else is done, as death or a seriously
weakened condition results. Elevat-ing
the limb and applying slight
pressure at the edge of the wound
with the finger or dressing is usually
sufficient to check bleeding, but for
cut arteries or large veins special
measures are necessary. If the blood
comes in a steady flow, it means a cut
vein; if in spurts, a cut artery. Arte-
February, 193Jt The Health Bulletin 13
rial bleeding is more serious because
the heart is directly behind, pumping
blood through the wound. To check
bleeding apply pressure above a cut
(between cut and heart) for an ar-tery,
and below the cut for a vein. To
get the necessary pressure to stop
bleeding, apply a tourniquet, a cloth,
handkerchief, bandage, etc., tied
around the limb and twisted tight.
This, of course, can be used only for
an arm or leg. Five points should be
remembered about a tourniquet:
1. It must be long enough to tie
around the limb.
2. There must be something to
make pressure at the artery greater
than on the rest of the limb: smooth
stone, watch, darning ball, or tightly
folded pad of gauze, etc.
3. This pad must be placed so that
the cut artery lies between the pad
and the bone so the pressure will
close the artery between the two
harder surfaces. For this one should
know the general location of the
blood vessels. Roughly speaking, the
principal vessels in the arm run about
like the inner seam of a coat sleeve,
and in the leg about in line with the
inner seam of a man's trousers.
4. Unless the tourniquet is tight
enough it increases bleeding. In such
cases remove the tourniquet. A short
stick or handle should be inserted in
the tourniquet and used to twist it
tight. Rarely can one be twisted tight
enough by hand alone.
5. Remember a tourniquet stops
most circulation in the whole limb
below the cut. For this reason it
should not be left on too long or it
may injure the rest of the limb. Usu-ally
it should not stay on more than
an hour. If necessary loosen it for
a while and tighten it later.
After bleeding is checked, if the
patient is very weak, give a stimu-lant,
but never give it until the bleed-ing
has been checked, as a stimulant
increases the heart action and conse-quently
increases the flow of blood.
All wounds have danger of infec-tion
leading to death through blood
poisoning or tetanus. Never neglect
even small cuts. My earliest realiza-tion
of death came at the age of
seven when a schoolmate died of
blood poisoning from infection of a
skinned knee. Infection may be
caused by germs on the object inflict-ing
the injury, from the patient's
clothes, from the hands of the res-cuer,
from water used in washing, or
unsterilized dressing used on the
wound. To prevent infection do not
wash, touch, or put anything into a
serious wound unless a doctor cannot
be found. If it must be cleaned be-fore
the doctor comes, use boiled wa-ter,
or water and alcohol half and
half. Unless there is need for im-mediate
action, before dressing a
wound, wash your hands thoroughly,
using soap, water, and a nail brush.
For minor cuts apply tincture of
iodine or 2 per cent solution of Mer-curochrome
into and around the
wound; apply a sterile dressing which
may be gotten ready for use at any
drug store and kept. In an emer-gency
a freshly washed and ironed
handkerchief or other freshly laun-dered
cloth may be used. Remember
an unsterilized dressing is worse than
none. If any signs of infection de-velop
in the next few days, call a
doctor at once, and meanwhile put on
hot compresses of normal salt solu-tion.
There is danger of tetanus, or as it
is commonly called lockjaw, especial-ly
when the wound is small and deep
or when it is made by a dirty or rusty
object. In such cases do not attempt
to dress the wound yourself, but take
the patient to the doctor for anti-tetanus
treatment as soon as possible.
Burns and Fire in Clothing
Burns frequently cause death, es-pecially
where the patient's clothing
catches fire. Where this happens,
wrap the patient in the first thing at
hand—rug, coat, blanket, etc.—wrap-ping
at the neck first to prevent
flames reaching face. Lay him on the
floor, rolling him over and smother-ing
the flames. If you have a chance
to choose, woolen material is better
than cotton, as it is less likely to
catch fire. If the fire is in your own
clothing, never run for help, as the
14 The Health Bulletin February, 1934
motion fans the flames more. Wrap
yourself in the nearest thing at hand
and smother the flames as before. If
there is nothing at hand, roll over
slowly and beat flames with your
hands wrapped in parts of the cloth-ing
not burning. Such fires always
cause serious burns, so send for the
doctor at once. Allay pain until he
comes by protecting burn from the
air by a paste of baking soda and
water. Gauze prepared with picric
acid may be bought at the drug store
and kept ready for emergencies. Re-member
that burns, like ordinary
wounds, are subject to infection, so
observe care in handling them. All
burns except very minor ones should
be treated by a doctor, but pain may
be allayed until he comes. It may
also be necessary to treat for shock.
Fi'eezing
Freezing may be fatal, but in this
climate it is less likely to be serious
than the other accidents discussed
here; but because of its seasonal
character it can be appropriately
treated at this time of the year.
Frostbite and freezing differ chiefly
in intensity, and the amount of the
body involved, but the treatment is
largely the same. The frozen parts
are an intense white without feeling
or motion; the patient may or may
not be unconscious. The important
thing is to restore circulation gradu-ally
to the frozen parts. Sudden
application of heat causes death
of frozen parts. Have the patient
in a cold room, rub him with
rough cloths wrung out in cold water,
or in severe cases with snow. Very,
very gradually increase the tempera-ture
of the room and of the water
used in rubbing. When the patient
can swallow, give stimulants. When
frozen parts become normal in color
and the tissues are soft, showing that
the circulation has been established,
then wrap patient warmly and give
hot drinks. In using hot-water bot-tles
at this time, put them outside
the blanket, as the patient is particu-larly
liable to be burned.
Know what to do if an accident
does happen. But the best treatment
for accidents is to prevent them.
a They Say"
Public health authorities and repu-table
physicians are performing a
worthwhile service by their warnings
of the danger of quacks, patent medi-cines,
and get-rich-quick specialists.
These warnings cannot be given too
often nor too loudly,
Man is a reasoning animal who for-gets
to reason when the situation
most demands it. The trust and faith
which the average person places in
hearsay statements regarding patent
medicine advertisements, get-rich-quick
specialists, and others of their
ilk is one of the paradoxes of human
intelligence.
Than "they say" no two words
when applied to the healing art do
more damage. "They say" prescribes
more medicine than all the doctors in
the country; and, incidentally, kills
more people.
"They say" that a certain old lady
can remove warts by the pow-wow
process; "they say" that this and the
other is good for headaches; "they
say" that the highly advertised medi-cine
in the ornate package will cure
twenty different diseases; "they say"
that the widely advertised doctor can
cure any disease in any stage. "They
say" and "they say." And millions of
otherwise sensible men and women,
without asking other proof, look up
the sorceress, patent medicine, or
quack, and spend their money to be
cured of a disease they never were
afllicted with.
The wise person will seek for a
more solid foundation for his health
condition than "they say." When
something goes wrong with his physi-ological
machinery he will consult a
thoroughly competent physician.
—
Chatham Neics.
Fehruary, 1934 The Health Bulletin 15
Measles
By D. F. Milam, M.D., Epidemiologist
MEASLES is one of the epi-demic
diseases that has its
rise and peak in the first half
of the calendar year, in contrast e.g.
to diphtheria, which attains its peak
in the fall. In the case of measles
the peak month is usually February,
March, or April; with the rise being
well under way in January, and the
course of the epidemic run through
by the end of May. Here is then a
very definite season of maximum
prevalence for measles.
Furthermore, it is evident in every
area of any considerable population
that the waves of epidemics of
measles are likely to be pretty well
spaced out at intervals of from two to
six years. In North Carolina the
longer period seems to hold for the
State as a whole; but it is always to
be stated that for measles an area as
large as the State of North Carolina
is too great to be considered an epi-demiologic
unit. Rather, each county
or each city would run its own course
in this regard without any great in-fluence
from remote sections of the
same state. However, the number of
areas running to epidemics in the
same year is so uniform that the fig-ures
for the State as a whole are very
valuable as an indication of the trend
and the probabilities as to impending
outbreaks.
With these general points in mind,
the following tabulation of reported
cases of measles in North Carolina
are of interest:
Year Cases Year Cases
1920 3.621 1927 32,882
1921 11,539 1928 60,543
1922 2,042 1929 1,209
1923 52,066 1930 1,376
1924 34.938 1931 15,449
1925 1,002 1932 13,672
1926 7,952 1933 16,088
There was a five-year interval be-tween
the peak years of 19 32 and
1928. This time last year a warning
was sounded that a great outbreak of
measles was imminent, but from the
above tabulation it is very evident
that it did not materialize. We are,
however, again calling attention to
the probability of a great rise in
measles incidence this spring, all the
more imminent for its failure to ma-terialize
last year. The rise had ap-parently
already begun in December.
In that month 2,425 cases were re-ported,
the largest for any December
since 19 2 7 and nearly double the
five-year average for the month. With
these facts in mind, we feel justified
in again announcing an impending
large outbreak of measles.
In the case of measles about 9 5
per cent of the population have an
attack at some time during their life;
the rest are either naturally immune,
die too soon, or have it too light to
seek medical advice and diagnosis.
For practical purposes we can call it
a universal disease. Now a few years
of low incidence builds up a large
group of young children who have
not been exposed to measles and so
have never had it. This group of
non-immunes is the fuel on which the
epidemic spreads. The greater the
fuel the more extensive the confiagra-tion.
This is the situation we are
confronted with now. Any communi-ty
not having had a large outbreak
of measles within the last two to five
years should consider a large epi-demic
as imminent.
So much for prophecy. Now what's
to be done about it? Much. It's worth
recalling that in the epidemic years
of 1923 and 19 2 8 over five hundred
children died of measles in each of
these years. Most of these deaths
were preventable. As a killer measles
in North Carolina ranks ahead of
scarlet fever, infantile paralysis, men-ingitis.
But it need not be so fatal.
One reason is that parents too fre-quently
regard it as just a childhood
disease that everybody has and for
which no special care or attention is
indicated. The facts are that if proper
attention through careful nursing and
medical care were given to all measles
16 The Health Bulletin Fel)ruary, 19Slf
patients this mortality would drop to
insignificant proportions.
Every measles patient should be re-garded
as suffering from an acute
illness and extreme care taken to pre-vent
the onset of complications, par-ticularly
pneumonia, which carries off
so many. Careful nursing is the an-swer,
with careful medical supervi-sion
by doctor to watch for complica-tions
and take prompt measures if
any appear. People are asleep to the
dangers of blindness following mea-sles,
to deafness following scarlet
fever, and the like. Fortunately,
measles is usually a mild disease, but
its possible complications when neg-lected
should be always kept in mind.
The fatalities from measles are
concentrated in the very young. Sixty
per cent of the deaths are in children
under five years. These are the ones
who are incapable of taking care of
themselves, and their deaths are
largely traceable to carelessness or
Ignorance on the part of their par-ents.
Not always, of course.
And this brings up the question of
preventing measles in the very young,
that is, delaying it until later when
the child is not so exposed to a fatal
issue. The best remedy, of course, is
to avoid exposure to another case. In
times of epidemics young children
should be kept at home, and if possi-ble
out of contact with other children
who are non-immune to measles. But
of course this is not always possible,
especially in families with two or
more children. Fortunately, we have
a measure of great value in the use
of convalescent serum. Such serum
from a recently recovered case can be
used to prevent measles if given with-in
five days of first exposure. Even
adult blood from one who had
measles many years ago can be used.
This procedure is, of course, a tech-nical
one requiring the doctor's skill
and judgment, but should be consid-ered
in exposed children under three
years. In one North Carolina city it
has been used with great success, so
that in a whole year no death from
measles in a child under three years
was reported. But more important
than this procedure is the careful
nursing and medical care of the
measles patient.
The advice regarding measles can
be epitomized as follows: Delay the
attack as long as possible. The best
time to have measles is about ten
years of age. Careful nursing and
medical care will prevent nearly all
fatalities. Convalescent serum should
be considered for exposed children
under three years of age.
Description of a Case of
Hookworm in Georgia in 1840
k
Mr. Wm. J. Andrews of Raleigh has
kindly sent us an extract from "Geor-gia
Scenes," published and copy-righted
in 1840. The book was writ-ten
by Augustus B. Longstreet, a na-tive
Georgian. Judge Longstreet was
not only a noted Southern author,
having founded the Augusta Sentinel
and contributed much to the famous
Southern Literary Magazine, but he
was a Methodist minister, lawyer, and
judge of the Superior Court, and for
many years president of the Uni-versity
of Mississippi at Oxford.
Following is his classic description
of an undoubted case of hookworm in
Georgia before 1840: M
"Ransy Sniffle ... in his earlier
days had fed copiously upon red clay
and blackberries. This diet had given
to Ransey a complexion that a corpse
would have disdained to own, and an
abdominal rotundity that was quite
unprepossessing. Long spells of the
fever and ague, too, in Ransy's youth
had conspired with clay and blackber-ries
to throw him quite out of the or-der
of nature. His shoulders were
fleshless and elevated; his head large
and flat; his neck slim and translu-cent;
and his arms, hands, fingers, and
feet were lengthened out of all pro-portion
to the rest of his frame. His
joints were large and his limbs small;
and as for flesh, he could not, with
propriety, be said to have any. Those
parts which nature usually supplies
with the most of this article—the
calves of the legs, for example—pre-sented
in him the appearance of so
many well-drawn blisters. His height
was just five feet nothing; and his
average weight in blackberry season,
ninety-five."
PJbli5\edbM T/\E.JS°KJ/iG^LI/iA STATE.D^ARDs^AEAUn
i Thi5 EiuJlelirvwillbe J>er\t free to arwj citizen of the State upoa request !
Entered as aecond-elusa matter at Poatoffice at Raleigh, N. C, under Act of July 16, 189^
Published rtuynthly at the office of the Secretary of the Board, Raleigh, N. C.
Vol. XLIX MARCH, 1934 No. 3
MOUTH HEALTH TEACHIIVa
School Dentist Using Stereopticon In Mouth Health
Teaching In the Schoolroom
MEMBERS OF THE NORTH CAROLINA STATE BOARD OP HEAI/TH
Carl V. Reynolds, M.D., President _ _ -Asheville
G. G. Dixon, M.D Ayden
S. D. Craig, M.D Winston-Salem
H. Lee Large, M.D _ „ Rocky Mount
J. N. Johnson, D.D.S Goldsboro
H. G. Batty, Sc.D _ Chapel HiU
W. T. Rainby, M.D _ _ Fayetteville
HuBCRT B. Haywood, M.D Raleigh
Jahbs p. Stowe, Ph.G _ _ _ - Charlotte
Executive Staff
Jambs M. Parrott, M.D., Secretary and State Health Officer.
G. M. CoopEa, M.D., Director Division of Preventive Medicine.
Wasrbn H. Booker, C.E., Director Division of Sanitary Engineering.
Ernest A. Branch, D.D.S., Director Division of Oral Hygiene.
John H. Hamilton, M.D., Director Division of Laboratories
and Vital Statistics.
M- V. ZiEGLEX, M.D., Acting Director Division of County
Health Work.
D. F. Milam, M.D., Acting Epidemiologist.
FREE HEALTH LITERATURE
The State Board of Health publishes monthly The Health BtJLLErnif
which will be sent free to any citizen requesting it. The Board also has
arailable for distribution without charge special literature on the follow-ing
subjects. Ask for any in which you may be interested.
Adenoids and Tonsils
Cancer
Coinstipation
Chickenpox
Diabetes
Diphtheria
Don't Spit PIae«rda
Eyes
Flies
Fly Placards
German Measles
Health Education
Hookworm Disease
Infantile Paralysis
Influenza
Malaria
Measles
Pellagra
Residential Sewage
Disposal Plants
Sanitary Privies
Scarlet Fever
Smallpox
Teeth
Tuberculosis
Tuberculosis Placard*
Typhoid Fever
Typhoid Placards
Venereal Diseases
Water Supplies
Whooping Cough
SPECIAL LITERATURE ON MATERNITY ANT) INFANCY
The following special literature on the subjects listed below will be sent
free to any citizen of the State on request to the State Board of Health,
Raleigh, N. C.
Prenatal Care (by Mrs. Max West)
"Our Babies"
Prenatal Letters (series of nine
monthly letters
)
Minimum Standards of Prenatal Care
Breast Feeding
Infant Care. The Prevention of
Infantile Diarrhea
Table of Heights and Weights
Baby's DaQy Time Cards : Under 6 months
;
5 to 6 months ; 7, 8, and 9 months ; 10,
11, and 12 months; 1 year to 19 months;
19 months to 2 years.
Diet List: 9 to 12 months; 12 to 15
months ; 15 to 24 months ; 2 to 8
years ; 3 to 6 years.
Instructions for North Carolina Midwives.
CONTENTS
PAGE
School Dentistry in North Carolina - - 3
State School Dentists With the North Carolina State Board of Health _ „ 4
Mouth Health Teaching in the North Carolina Schools - 5
School Dentists and School Children „ - •- 7
It Is Playtime When First Grade Children Go to the School Dentist 9
Ultimate Aim of Mouth Health Programs - 11
How Mouths of Children in Hall-Fletcher Junior High School Were Made Dentally Fit- 12
What Our Friends Have to Say About the Mouth Health Program _ — 13
Building Our Teeth - - 14
Mouth Health Programs in the Counties (Map) — 16
Vol. XLIX MARCH, 1934 No. 3
SCHOOL DENTISTRY
IN NORTH CAROLINA
FOR this month's issue the veteran editor of THE HEALTH BUL-LETIN
is vacating his chair to Dr. Ernest A. Branch, who for the
past five years has been Director of the Dental Division of the State
Board of Health. Dr. Branch and his capable assistant, Miss Mary
Batchelor, have written or assembled all the material published this
month.
On the 10th day of July, 1918, the editor of THE BULLETIN, as
Director of the Department of Medical Inspection of Schools, em-ployed
six young dentists and started them out with portable dental
equipment to teach the school children of the State the meaning of
mouth health and care of the teeth. The first work was commenced
on the above date in a small rural school in Nash County.
Since that beginning sixteen years ago the work has never ceased
during school hours. It has been one of the greatest contributions to
health and happiness of the people of this State ever inaugurated \yy
the State Board of Health. WTien the work started 95 per cent of all
school children in the State were in need of immediate dental service.
Fewer than five out of each hundred who needed dental work had
ever seen inside of a dentist's office. Today in many of the schools
of the State everj' child in need of dental attention has had it; and
in many schools 50 per cent or more of the children in certain grades
have perfectly cared for teeth. The work has been strictly educa-tional
and has succeeded in reaching the parents as well as the chil-dren.
One of these dentists has demonstrated one or more times in
every public schoolhouse in North Carolina. Dr. Branch is a teacher
of great ability, and since he took over the direction of the work has
succeeded in arousing widespread interest among the dental profes-sion
and the people. One of the great satisfactions of the editor of
THE HEALTH BULLETIN is the knowledge that he was able to
inaugurate, organize, and execute this great work from the beginning
in 1918 and for eight years thereafter; and that the organized dental
profession enthusiastically aided him in every way in the support of
the work.
The work has been encouraged and supported through appropria-tions
by the Legislature, county and city boards of commissioners
and education, by industrial corporations, and individuals. The
demonstration work has been confined to school children between
the ages of six and thirteen, but the influence has been felt by all
of them. Every class of children among both races has been influ-enced.
If Dr. Mayo's statement that 80 per cent of all the ailments
of humans may be attributed to mouth origin is correct, then the
next generation of North Carolina should be a healthy people.
STATE SCHOOL DENTISTS WITH THE N. C. STATE BOARD OF HEALTH
1. Dr. D. W. Dudley
2. Dr. H E. Butler 6. D8. W. I. Farrell
3. Dr. Vaiden Kendrick 7. Ernest A. Branch
4. Dr. L. E. Buib Director
9. Dr. J. A. Oldh.\m
10. Dr. Gates McKaughan
11. Dr. a. D. Underwood
5. Dr. M. R. Smith 8. Dr. a. J. Pringle 12. Dr. L. R. Thompson
13. Dr. a. C. Early
14. Dr. a. L. Wootbn
15. Dr. W. L. T. Miller
16. Du. Robert M. Bell
;
17. Dr. L. C. Holliday .
Mouth Health Teaching in the North
Carolina Schools
DR. GEORGE M. COOPER, a physician connected with the North Caro-lina
State Board of Health, was, so far as we are able to determine,
the first public health official to place dentistry in a public health
program. This was in 1918. In 1919 North Carolina was one of the first
states to have a dentist as a member of the State Board of Health, and in
1931 was the first State to enact a law making a dentist a member of every
county board of health. Dr. James M. Parrott, upon his election in 1931 as
State Health Officer of the North Carolina State Board of Health, dignified
the profession in North Carolina by making the Division of Oral Hygiene
a separate and distinct entity of the Board of Health.
The purpose of the Division of Oral Hygiene of the North Carolina State
Board of Health is not
to operate free dental
clinics, but to teach the
value of oral hygiene
in the prevention of
disease.
The dentists in this
department are trained
as teachers and are
capable of going into
any classroom and
teaching the subject of
oral hygiene, which is
based on foods, food
values, and proper
health habits. In our
didactic teaching in
the classroom visual
methods are used,
namely, models, plac-ards,
blackboard draw-ings,
stereopti con
slides, etc.
D e n t al corrections
are also used as a
means of visual in-struction.
The neces-sary
dental work is
done for as many chil-dren
as possible, pref-erence
being given to
grade repeaters. In
this part of our pro-gram,
before any work
begins, the child is
Dr. G. M. Cooper shown his own mouth
a physician and Director of Preventive Medicine of the North in a large mirror and
Carolina State Board of Health, who was the first public health ^jjg existing conditions
official in the United States to place dentistry in a public health , . , _, .
program. explained. This gives
The Health Bulletin March, 19S4
the dentist-teacher an opportunity to
reemphasize the health truths
brought out in the classroom teach-ing.
Of course, the number worked
for is reduced to a minimum because
we do not reach as many with actual
dental work in this way as we would
had all of our time been spent at the
chair, but those who are fortu-nate
enough to be used for demon-strative
purposes have all necessary
dental corrections made in the very
best manner possible. Those who re-quire
dental attention and do not
receive it in school are urged to visit
their family dentists.
This method of teaching allows the
grade teacher to correlate Mouth
Health with "reading, writing, and
'rithmetic," history, geography, spell-ing,
etc. It is easily tied in with the
projects and activities of farm
agents, home demonstration agents,
4-H clubs, calf clubs, home economics
work, and vocational agriculture, as
these are all closely associated with
foods, food values, and proper health
habits.
The financing of this activity is
borne jointly by the State Board of
Health and local budgets. Local bud-gets
include schools, parent-teacher
associations, civic clubs, etc.
The director of the Division of Oral
Hygiene is a dentist, and in addition
to directing the activity, he spends
the major portion of his time lectur-ing
in grade schools, high schools,
teacher-training institutions, parent-teacher
associations, women's clubs,
and civic clubs.
—
The Journal of the
American Dental Association.
The Best Mouth Health Record In the State. Only One Cavity In One
Tooth In the Entire Group. All Homes Represented
Have Cows and Gardens
March, 1934 The Health Bulletin
School Dentins and School Children
By Mary S. Batchelor
SAY there is nothing new under
the sun and believe it if you will,
but prepare for a rude awaken-ing
when in these enlightened days
and times you see the younger gener-ation
dancing with pleasant anticipa-tion
over an impending visit to the
dentist! That is new!
To those of us who are no longer
classed as children, there are memo-ries
which, if conjured up, can still
cause cold sweat to stand upon our
brows and make horrible shivers start
at our feet and shake us to the core.
Such a memory is that of the pulling
of loose teeth not so many years ago.
Don't you remember the method in
vogue—the string tied to th

THE LIBRARY OF THE
UNIVERSITY OF
NORTH CAROLINA
AT CHAPEL HILL
THE COLLECTION OF
NORTH CAROLINIANA
C61U
N86
1930-3U
C.2
This book is due on the last date stamped
below unless recalled sooner. It may be
renewed only once and must be brought to
the North Carolina Collection for renewal.
form rvo. (is-.^oy
MR. JRC. G. BEAPDf
CFAPEL HILL» H. C u.
^HfedMb 'IEjqiiI
Thi5 Bdlelirvwillbe 5er\t free to arwj citizen of the State upo:\ request.
|
Entered as second-class matter at Postoffice at Raleigh, N. C. under Act of July 16, 1S9U
Published monthly at the office of the Secretary of the Board, Raleigh, N. C.
Vol. XLIX JANUARY, 1934 No. 1
NORTH CAROLINA HEALTH CALENDAR
for 1934
Some Things Our Citizens Should Endeavor To Do
1. Reduce the infant death rate.
2. Reduce the maternal death rate.
3. Extend organized health service to every county.
4. Increase the per capita consumption of safe milk.
5. Work for the day when no citizen shall suffer or die from a pre-ventable
disease.
6.
8.
9.
10
Continue the efforts to completely eradicate pellagra and small-pox.
Immunize every baby in the State against diphtheria at Six
months of age.
Extend the benefits of approved sanitary facilities to include
every rural home.
Provide competent prenatal medical seivice and medical care
for all maternity cases.
Through regular and thorough medical examination and consist-ent
medical care prevent untimely deaths from such killers as
cancer, tuberculosis, and the many diseases of heart and kidnejs.
11. Secure a more widespread system of medical supervision of the
health of school children, with a more effective system of follow-up
which will provide for the removal of all remediable physical
handicaps; and care for every malnourished child in the com-monwealth.
12. Strive for a health-minded population who will eventually realize
the benefits of positive health, and who will be just as willing to
pay for competent medical and dental service when needed to
preserve good health as they are now ready to pay out money
for any of the other desirable possessions of life.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
Carl V. Reynolds, M.D., President Asheville
G. G. Dixon. M.D ' Ayden
S. D. Craig. M.D Winston-Salem
H. Lee Large, M.D Rocky Mount
J. N. Johnson, D.D.S Goldsboro
H. G. Baity. Sc.D Chapel Hill
W. T. Rainey, M.D Fayetteville
Hubert B. Haywood, M.D Raleigh
James P. Stowe, Ph.G Charlotte
Executive Staff
James M. Parrott, M.D., Secretary and State Health Officer.
G. M. C00PE3S, M D., Director Division of Preventive Medicine.
Warren H. Booker, C.E., Director Division of Sanitary Engineering.
Ernest A. Brakch, D.D.S., Director Division of Oral Hygiene.
John H. Hamilton, M.D., Director Division of Laboratories
and Vital Statistics.
M. V. ZlEGLER, M.D., Actinsr Director Division of County
Health Work.
D. F. Milam, M.D., Acting Epidemiologist.
FREE HEALTH LITERATURE
The State Board of Health publishes monthly The Health Bulletin
which will be sent free to any citizen requesting it. The Board also has
available for distribution without charge special literature on the follow-ing
subjects. Ask for any in which you may be interested.
Adenoids and Tonsils
Cancer
Constipation
Chickenpox
Diabetes
Diphtheria
Don't Spit Placards
Eyes
Flies
Fly Placards
German Measles
Health Education
Hookworm Disease
Infantile Paralysis
Influenza
Malaria
Measles
Pellagra
Residential Sewage
Disposal Plants
Sanitary Privies
Scarlet Fever
Smallpox
Teeth
Tuberculosis
Tuberculosis Placards
Typhoid Fever
Typhoid Placards
Venereal Diseases
Water Supplies
Whooping Cough
SPECIAL LITERATURE ON MATERNITY AND INFANCY
The following special literature on the subjects listed below will be sent
free to any citizen of the State on request to the State Board of Health,
Raleigh, N. C.
Prenatal Care (by Mrs. Max West)
"Our Babies"
Prenatal Letters (series of nine
monthly letters
)
Minimum Standards of Prenatal Care
Breast Feeding
Infant Care. The Prevention of
Infantile Diarrhea.
Table of Heights and Weights
Baby's Daily Time Cards : Under 5 months ;
5 to 6 months ; 7, 8, and 9 months ; 10,
11, and 12 months; 1 year to 19 months;
19 months to 2 years.
Diet List: 9 to 12 months; 12 to IB
months ; 15 to 24 months ; 2 to 3
years ; 3 to 6 years.
Instructions for North Carolina Midwives.
CONTENTS
page
Notes and Comment 3
Rules and Regulations for the Control of Psittacosis 6
About First and Latest Presidents N. C. State Board of Health 7
Infectious Diseases We Don't Talk About 9
Eating Habits - - ^^
North Carolina Turns Over a New Leaf in Public Health 13
Amoebic Dysentery ^^
Ignorance More Malignant Than Cancer - - 16
Suggested New Year Resolutions 16
PUBLI5AE:D by TML noR.TA CAeOLIMA 5TATL BQAIgP s^AEALTM
Vol. XLIX JANUARY, 1934 No. 1
Notes and Comment
ANEW YEAR lies before us. A
new year with new possibili-ties,
new liabilities, new adven-tures,
new disasters, and new oppor-tunities
spreads out before us like an
unknown road. The only criterion we
have for intelligent speculation as to
what mankind may expect during this
new year is by a study of what the
innumerable new years of the past
have disclosed. In many respects this
new year begins at a time when con-ditions
all over the world are probably
more disturbed than at any other time
since the beginning of recorded his-tory.
The years of the World War
were upsetting, but many thickly pop-ulated
regions of the earth scarcely
knew what was going on. The years
of the American Revolution and of the
French Revolution upset the world
very largely, and yet such densely
populated countries as China knew
nothing of what was going on outside
of their own country. At present there
is not a civilized or half-civilized
country in the world but what is in
an unstable condition.
For our own country, and for North
Carolina in particular, our concern is
tor the protection of the public health.
It is interesting to note a comparison
which may or may not be altogether
to the credit of the present organiza-tion
of the State Board of Health.
The reason we make that statement is
that the present organization have
means and personnel which were lack-ing
twenty-five years ago. Twenty-five
years is not a very long period as time
is recorded. In The Health Bulletin
for January, 1909, just twenty-five
years ago, among other things, the
late Dr. Richard H. Lewis, at that
time Secretary of the Board and State
Health Officer, printed the following
appeal to the General Assembly, then
in session:
"The great work is the general work
of the Board of Health. A sine qua
non in the proper performance of this
work is a competent Secretary, who
shall be required to devote his whole
time to it. Such a man, one who has
proven himself a success, cannot be
obtained for less than three thousand
dollars a year. He should have a good
assistant for the office work, while he
is absent, investigating outbreaks of
disease and educating the people by
public addresses and by advice to
health boards and health officers. This
assistant should also have charge of
the collection and tabulation of vital
statistics. A first-class stenographer
is a prime necessity."
Doctor Lewis, in this editorial,
points out that his total income as
State Health Officer was $750, that he
had to make his living by the practice
of medicine, and that as a consequence
the health work of the State had nec-essarily
been a side issue and a sec-ondary
matter. Doctor Lewis speaks
of "health officers." He meant part-time
physicians. There was not a
whole-time health officer in the State
at that time, and not until many years
afterward.
Be it said to the credit of the Gen-eral
Assembly, it responded with en-thusiasm
to Doctor Lewis's appeal and
made provision for a whole-time State
Health Officer and an "assistant for
office work," and a "first-class stenog-rapher,"
which Doctor Lewis was
pleading for, and a lot more. On July
1st following. Dr. W. S. Rankin, the
The Health Bulletin January, 1934
State's first whole-time State Health
Officer, assumed his duties. Today
there is an average of about eighty-five
whole-time employes of the State
Board of Health. In place of an office
assistant to "have charge of the collec-tion
and tabulation of vital statistics,"
there are about eighteen whole-time
employes in that department alone.
At present there are about ten stenog-raphers
instead of the one first-class
stenographer Doctor Lewis was re-questing.
The question for the present organi-zation
is this: Have we, In accordance
with the opportunities which have
been ours for the work of the public
health, done as much with our means
as Doctor Lewis accomplished with his
$250-a-year statistician? We leave it
to the people of North Carolina to
render judgment. Doctor Lewis's
chief contribution was in the building
of a foundation of good-will and the
creation of a desire on the part of the
people for the right kind of public
health service.
We hope that the contribution of
the present organization has measured
up fully to what might have been ex-pected
of it. We know that some dis-eases
have been almost eliminated;
some diseases which were very preva-lent
twenty-five years ago have become
rare at this time. Twenty-five years
ago we had no means of preventing
diphtheria; we had no means of pre-venting
typhoid fever, except through
sanitation; we had the means for pre-venting
smallpox, but for lack of or-ganization
and money to pay for pub-lic
health service that disease was
very prevalent. Many deaths occurred
every year. At this time we still have
diphtheria with us. We do not yet
have a tabulation of deaths occurring
in 1933 from diphtheria, but we know
there were a large number that could
and should have been prevented. Al-though,
by means of preventive treat-ment
and improved sanitation every-where,
typhoid fever has been greatly
reduced, it is still prevalent in many
sections of the State. The eradication
of preventable diseases is a slow and
tedious process. Practical knowledge
about how to prevent disease and how
to protect one's health is educational
matter in which each individual may
obtain information for himself. Health
education is a perennial interest; the
story has to be repeatedly told, and
our work is not yet done. It never
will be finished.
If we are able to make the same
progress during the next twenty-five
years that we have in the last twenty-five,
in January, 1959, some future
editor of The Health Bulletin may
be writing in these columns that ty-phoid
fever, diphtheria, tuberculosis,
and all the other preventable diseases
are gone from the confines of North
Carolina. Let us hope that the part
we may play this year will advance
the cause more than any other year in
the past.
* * *
FROM time to time we have called
attention in The Health Bulletin
to the menace of trichinosis, that is,
a parasitic infection in pork. We try
to do this sometime during every
winter in order to warn our folks who
might be inclined to eat their pork
raw, or half-cooked. Outbreaks of
this malady occur at frequen,t inter-vals
all over the country. It is caused
by a parasite in hogs, and it is said
that between 2 to 5 per cent of all the
hogs in the United States are infected.
Infected pork has been discovered
in practically every section of the
country at one time or another. There
is no present method of meat in-spection
which will discover the pres-ence
of this parasite. We mention
this so that people in the cities and
towns will place no reliance whatever
on a meat inspection service. The
meat inspectors in all of the larger
cities and towns of the State protect
,
the people from many sources of dis-ease
by discovering meat that is not
fit for human consumption; but, as
just stated, there is no form of inspec-tion
yet discovered which will enable
an inspector to find the evidence of
trichina in the meat. With the ever
increasing consumption of "hot dogs"
and other half-cooked or downright
raw pork at all kinds of roadside
stands all about over the State, it is
very necessary to put people on their
V
Januai-y, 193Jf The Health Bulletin
guard against this infection. Once the
parasite is established in the tissues
of the human body, it is very hard to
eradicate. There is no known medical
treatment which is effective in curing
a patient. In many cases the symp-toms
of the disease are very similar
to typhoid fever.
Late in the summer, in Westchester,
New York, the health officer for that
county reports that nine families,
comprising thirty-four individuals, all
mutually acquainted, spent a few days
at a camp. Later all suffered from
the disease. They had the customary
habit of many campers, of building a
camp-fire and cooking their own food
outdoors, specializing in frankfurters
and hamburgers, the latter composed
of about three parts of beef to one
part of pork. Cooking before an open
fire outdoors naturally meant that the
food was not even half-cooked. Other
sections of the country have reported
having had trouble with this infection
from time to time; for example, the
Connecticut Board of Health has re-cently
reported 107 cases of the dis-ease
having occurred in that state
during the past ten years. The para-site
is easily destroyed by cooking the
meat thoroughly before eating it. The
main danger in outdoor cooking and
in cooking pork sausage and so on in
frying pans is that the outside portion
may be cooked sufficiently hot, heating
to 145 degrees or more, which will de-stroy
the parasite; but the inside of
the portion, not being heated to any
such temperature in a shallow pan or
before an open fire, is not thoroughly
cooked, and the parasite is not killed;
therefore, infection easily follows eat-ing
such half-cooked meat.
The purpose of this mention here is
to urge upon people again, for their
own protection, the importance of
thoroughly cooking all pork before it
is eaten.
* * *
RIDING along the road the other
day in Cumberland County, the
editor noticed a roadside sign which
read something like this: "One mile
to John Smith's gristmill and dairy."
If such a sign could be located about
every ten miles on all public roads in
North Carolina, deficiency diseases,
such as pellagra, would soon become
but a memory. This sign, indi-cating
a plentiful supply of freshly
ground corn-meal from sound native
corn, and fresh milk and all the dairy
products that go with it, reminded
the editor that Dr. James A. Tobey
sometime ago wrote a very interest-ing
article under the title of "Bread,
the Universal Food." Doctor Tobey
made the following statement: "Mal-nutrition
can be averted at all times,
and especially in periods of economic
stress, by following one simple rule.
According to the consensus of scien-tific
opinion, it is merely this: build
the daily diet around bread and milk."
That should be the ticket for North
Carolina this coming year: build the
daily diet of every family around milk
and bread. Bread does not necessarily
mean corn-bread alone, but white-flour
bread, whole-wheat bread—bread of
different kinds. Add to this the nec-essary
variety of vegetables, eggs,
fruit, and some meat, and any family
has a diet that protects, provides fuel
and energy for the daily needs of
adults, and for the health and growth
demands of growing children. In
short, this Cumberland County road-side
mill and dairy owner is prepared
to supply to his neighbors and cus-tomers
the elements which Doctor
Tobey considers the foundation of the
daily diet. All the rest should be
built around that.
* * *
THE editor's official duties took him
about a good bit over the State
during the fall, and always on the
alert for items which would be bene-ficial
to the readers of The Health
Bulletin, he makes it a point to look
about him on his travels. Late in
November he had occasion to visit
several points in Eastern North Caro-lina.
Passing through one fine little
town about one o'clock, and noticing
that the town looked so clean and the
odors around the hotel were so appe-tizing,
he pulled up to the curb and
parked and decided to take his midday
meal right there. Opening the door, he
entered the coffee shop of the local
hotel from the street entrance. He
The Health Bulletin January, 193Jf
stepped into as clean and appetizing
place as he has visited in a long time.
The room and the floor and the tables
and the linen were all spotless. The
food was well prepared, well balanced,
clean, and wholesome. As the day was
cold, the editor yielded to what some
people would call his "bad habit," and
called for a cup of coffee. It came
steaming hot, and looked good. Ac-companying
the coffee, however, was
a tiny container about two-thirds full
of milk. Eastern North Carolina sim-ply
will look on milk as too precious
for human consumption. Fixing the
coffee up, however, and getting ,i taste,
he discovered that the milk was
canned condensed milk, something
that he could never endure. It well-nigh
destroyed the joy in the meal
entirely. The thought of having to
put up with canned condensed milk
in a section that should be literally
flowing with milk and dairy products
was too much.
Now here comes the funny part of
the experience. More or less deter-mined
to have his coffee anyhow, he
requested the waitress to take the
oily, greasy, condensed-milk mixture
back and to bring along some plain
coffee. She readily agreed, but like a
good waitress inquired the trouble.
On being told, she replied: "Oh, we
have some fresh milk if you prefer it."
She returned to the refrigerator and
brought out from a carefully hidden
corner about a thimbleful. So the
editor got his coffee flavored, at least,
with fresh milk. Further inquiry
brought out the information that most
of their customers took their coffee
straight or preferred condensed milk;
but during the last year or two "more
cranks seemed to be coming along
who insisted on fresh milk." And
frankly she did not like the way these
"cranks" insisted on Grade A Milk.
The reader may imagine the editor's
delight that night on reaching his
destination late and cold in another
fine little town still farther east, on |
walking into the hotel restaurant,
to see State Board of Health post-ers
all over the place announcing
"Grade A Milk Sold Here." And when
the coffee came in it was accompanied
by a man-sized pitcher of real fresh
cream. What with some of the finest
trout fresh from the sea and superbly
cooked—but that is another story.
Now, that Governor Ehringhaus has
succeeded in getting the farmers of
the eastern section a living price for
their tobacco, perhaps he can induce
them to invest some of their surplus
cash in good milk cows. What a
break that would be for the many
thousands of fine children who need
milk for proper growth, but who do
not get it now.
Psittacosis
Rules and Regulations for the Control of Psittacosis
BY virtue of the authority vested
in the North Carolina State
Board of Health, under Consoli-dated
Statutes, Chapter 118, Public
Health, Article 9, Section 7151 to Sec-tion
7155, the State Board of Health,
on August 15, 1933, declared psittacosis
to be an infectious disease; and sub-ject
to laws and regulations governing
notification and methods for dealing
with sources and modes of infections
of such diseases.
NoTiFrcATiON : 1. Cases of psittaco-sis
must be reported within twenty-four
hours—preferably by telephone
or telegraph.
Isolation: 2. The patient sick with
psittacosis shall be isolated in a sepa-rate
room, and no person other than
the local health officer or his repre-sentative
or a representative of the
State Board of Health, the attending
physician, the nurse, or attendant,
shall be permitted to enter the room
in which the patient is isolated or
quarantined.
In the event a friend or member of
the family should desire to be with
January, 193-'t The Health Bulletin
the sick one, such a person shall re-main
in quarantine for such a time
as the local or State Health Depart-ment
may determine.
Concurrent disinfection of all dis-charges
and articles must be carried
out and terminal disinfection insti-tuted.
Quarantine: 3. The premises in
which the patient is isolated are to be
placarded and quarantine instituted
until complete clinical recovery or
death of the patient.
Contacts: 4. It is advised that
household contacts be kept in quaran-tine
for at least five days following
last exposure, and under close obser-vation
for at least three weeks. The
exact incubation period of psittacosis
is unknown, but can be very long and
drawn out. Less intimate contacts
should be kept under careful observa-tion
as far as possible.
Birds: 5. Canaries, macaws, par-rots,
parrakeets, and other psittacine
birds that have been exposed to psitta-cosis,
either through birds known to
be infected with psittacosis or having
been associated with birds proven to
be probable sources of human cases,
must be killed and burned promptly.
This measure is to be ordered either
by the city, county, or State Depart-ment
of Health in each case, and no
indemnity provided.
Birds not of the psittacine family
are all to be regarded as potentially
dangerous when they have been ex-posed
to psittacosis, and after expo-sure
must be kept under close super-vision
and quarantine for a period of
not less than three weeks, and then
released only if no sign of psittacosis
has occurred amongst them.
Shipment: 6. Shipment of birds
into North Carolina by any means of
transportation whatever shall conform
to the regulations of the Federal Gov-ernment
covering this point.
The above rules and regulations
were adopted and approved by the
Executive Committee of the State
Board of Health in session on Decem-ber
5, 1933, and ordered promulgated.
James M. Pakrott,
Sec.-Treas., State Board of Health,
and State Health Officer.
About Fir^ and Late^ Presidents N. C. State
Board of Health
BEFORE we had time to comment
on the editorial of Editor Peter-son
in his journal for September
1st about Dr. Satchwell, our friend,
John M. Gibson, editor of the Sanato-rium
Sun, came along in his October
issue quoting the editorial as follows:
"The following brief article, headed
'A Great Old Physician,' appeared in
The State's Voice for September 1,
and no doubt will be of much interest
to patients, ex-patients, and friends
generally of the N. C. Sanatorium:
" 'My mind was carried back to a
great old physician when I met Quin-cey
Satchwell the other day. He is a
son of Dr. S. S. Satchwell, who died
nearly two score years ago. Dr. Satch-well
was one of the few physicians in
the State who had studied abroad.
He was a graduate of a Paris univer-sity,
and it was over there that lie
got the poison in his system that af-fected
his nose in such a way as to
make him a marked man for the rest
of his life.
" 'Highly educated as he was, and
skillful physician that he was, he
spent the greater part of his life in
country or village practice. He was
an old man when I went to Burgaw
as a teacher forty-one years ago, but
he was still intellectually strong. The
theory of ozone as a product of the
pitch-pine forests was Dr. Satchwell's,
if I mistake not. Anyway, he was a
champion of it, and that doctrine, with
the inferred effects upon consumption
of residence in the pine belt, had no
little influence in turning the one-time
flow of consumptives to the sandhills
of North Carolina, whatever merit
8 The Health Bulletin January, 193ff
there was, or is, in the theory. The
theory is probably responsible, also,
for the location of the State Tubercu-losis
Sanatorium where it is.'
"
This was a most interesting re-minder
to us for the reason that Dr.
Satchwell was the first member of the
N. C. State Board of Health and its
first president. Both Editors Peterson
and Gibson failed to mention that fact,
possibly because neither knew about
it. So, for the benefit of all of our
readers, we quote the following para-graph
from a paper written by the
editor of The Health Bulletin a few
years ago:
"On May 23, 1877, during the meet-ing
of the North Carolina Medical So-ciety,
which was held that year at
Salem, North Carolina, Dr. S. S. Satch-well,
of Rocky Point, Pender County,
was made the first president of the
State Board of Health, and Dr.
Thomas Fanning Wood its first secre-tary,
these ofiicials being designated as
'chairman' and 'secretary,' respec-tively,
of the committee of the State
Medical Society having in charge the
fortunes of the newly proposed State
Board of Health. This meeting was
immediately following the adjourn-ment
of the Legislature that year, at
which time the first law creating the
board was enacted. It may be inter-esting
to note in passing that on that
occasion Dr. Satchwell read an impor-tant
paper entitled, 'Duties and Use-fulness
of the State Board of Health.'
This paper made such an impression
that the society voted unanimously to
remit all dues to Dr. Satchwell for
the remainder of his life 'as a slight
testimonial of the regard of the so-ciety.'
On that day the first machin-ery
of organizing the State Board of
Health was definitely set in motion."
On Monday, November 13, 1933, Dr.
Carl V. Reynolds, of Asheville, was
elected president of the State Board
of Health. From May 23, 1877, to
November 13, 1933, is not a very long
period, as time is measured; but much
history has been made by the State
Board of Health in those fifty-six
years. Not many men have served as
president of this organization, possi-bly
a half-dozen, and not one of them
has been held in higher esteem by his
fellows than Dr. Satchwell, its first
president. Dr. Reynolds has been a
valued member of the Board for two
years, but, of course, he has not yet
had an opportunity to establish a
reputation as president. However, he
is not without a record in his home
town. Lest the editor, as a minor
employe of the Board, be suspected of
"boot-licking" his chief, we will let
the Asheville Times present the new
president to our readers:
"A pioneer in public health work is
again deservedly honored in the unani-mous
election of Dr. Carl V. Reynolds, ,
of Asheville, as president of the North \
Carolina State Board of Health.
"Those who knew not the Asheville
of the nineties nevertheless have
heard how Dr. Reynolds, as city health
officer, put Asheville on the public
health map of the United States.
"He had peculiar gifts for the work,
and especially for the unceasing,
never-wearying, many-sided educa-tional
labors which public health in
those days demanded far more than
now.
"Health Officer Reynolds stirred up
the professional brethren, and the alert
and the lazy laymen, on such subjects
as pure milk, the wrapped loaf, and a
vigorous warfare on the housefly.
"His bacteriologist and field mar-shal
was the late Dr. L. M. McCor-mick,
and Reynolds and McCormick
swatted the fly with swats that, if not
heard around the world, were heard
all around the United States. Before
that battle began in Asheville, most
people in this country had accepted
the common fly as part of the common
fate that had to be endured, no mat-ter
what the cost.
"This is recalled here to emphasize
once more the State's good fortune in
having Dr. Reynolds on the State
Board of Health. The Board's work
is now severely limited in some phases
of it by the general trimming down
of the State budget. Dr. Reynolds
can be counted upon to cry aloud and
spare not in arousing the people to
preserve what they have in public
health achievements, and to press on-ward
at every opportunity."
January. 1934 The Health Bulletin
Infedlious Diseases We Don't Talk About
By Wm. D. Riley, Consultant, Venereal Disease Control
THERE seems to be an instinctive
disposition on tlie part of most
people to avoid looking unpleas-ant
facts in the face. This disposition
is manifested not only when individ-uals
are confronted with the daily
problems of life, but it is also all too
frequently evidenced in problems of
disease. Especially is this true in the
case of that group of infectious dis-eases
known as venereal, of which
syphilis and gonorrhea are the most
important as public health problems.
The idea that the venereal diseases
are spread through intimate personal
contact has seemed and still seems re-pugnant
to some minds. But this re-pugnance
is due, perhaps, to a confu-sion
of thought in those minds rather
than to any essential objection in the
conception of these diseases.
Because of this confusion of thought
the venereal diseases have too long
been camouflaged under the term "so-cial
diseases," a term which justly in-cludes
all infectious diseases. While
the origin of this term can be readily
understood by even the most unimag-inative,
when used in this way it is an
unfortunate commentary on human
nature. It is true that essentially we
are social. Indeed, if we are to live
our lives fully and completely we must
be socially inclined. In order to main-tain
our balance of sanity and health
it is quite necessary that we share
the warm companionship of our fel-low
beings. Without this desire for
social contact, or when shunned by
society, people eventually fall subject
to mental disorders, usually. Some-one
has said that the three great hu-man
drives are "being social, occup?.-
tion, and love." Being social includes
the other two. But the ironic part of
it is that in being social so much trag-edy
frequently descends upon man.
Due to the fact that the venereal
diseases are spread largely through
sex contact, they have, until recent
years, been looked upon as the skele-ton
in the closet of society. They were
considered the inevitable wages of sin.
They were hidden behind a thick veil
of secrecy. A great wall of science
was built up around them. They were
considered unmentionable in mixed
groups, and when discussed at all, they
were talked about in whispers. They
were considered just retribution for
promiscuity instead of serious com-municable
diseases that not only rob
its victims of health and happiness
and even life itself, but endanger oth-ers
in social contact with them.
But the curtain has been raised on
the vast fester of venereal disease
which, like some huge poisonous oc-topus,
has been spreading its infected
tentacles indiscriminately into count-less
thousands of individuals and dis-integrating
the social and economic
fabric of the nation.
Prior to the year 1917 compara-tively
few people had either any idea
of the prevalence of the venereal
diseases or any knowledge of their
disastrous effects. But the importance
of syphilis and gonorrhea in deplet-ing
the manpower of the country
was forcibly brought to public atten-tion
during the World War.
When the first million draftees
were being examined for physical fit-ness
those who were found to be
venereally infected were rejected as
being unfit to assume the burdens
and responsibilities of warfare. The
rate of infection among these men
was so alarmingly high as to startle
the military authorities; and amaz-ing
as it may seem, the number of
men thus rejected was so great that
it was believed impossible for Amer-ica
to raise an army of sufiicient
strength to carry on its part of the
war unless infected men were accept-ed
and made fit to fight. Accordingly,
the men who were returned to civil
life in the first draft call on account
of venereal infection, and those found
to be venereally diseased in subse-quent
draft calls, were inducted into
service, placed in base hospitals, and
10 The Health Bulletin January, 193Jf
treated before they were instructed
in military tactics.
Prior to that time, too, not enough
thought was given to these diseases
to cause any action to be taken to
control them. Very little thought was
given to those persons who innocently
contracted these diseases, and prac-tically
no effort was made to extend
aid to the helpless. And the vast
force of sex, the motivating power of
humanity, the lever for both good
and evil, happiness and misery,
through the medium of which the
venereal diseases are usually trans-mitted,
was almost entirely ignored.
It is indeed tragic that the urge
for happiness and the search for com-panionship
and gaiety should often-times
have such dire results as vene-real
disease, not only to the indi-vidual
alone, but even "unto the third
and fourth generations." The homes
for the feebleminded, the institutions
for the blind and the deaf, and the
hospitals for the insane are harsh
proof of this deplorable fact.
Now, it seems strange that well-informed
men and women are com-monly
quite uninformed concerning
the nature of the extremely danger-ous
and highly prevalent venereal
diseases; and it seems stranger still
that, in many instances, these same
men and women are content to re-main
uninformed on the subject.
Knowledge regarding the venereal
diseases which cause so many dam-aged
lives and which can be so easily
and so innocently contracted should
not be repellant to intelligent minds.
An infected husband or wife may un-wittingly
infect a marital partner.
Through no fault of its own, a baby
may be blinded at birth by gonorrhea,
or may be born dead as a result of
syphilis, or, if it lives, may be so
riddled with the disease as to make
life itself seem a great misfortune.
Little girls frequently contract gon-orrhea
from contact with older per-sons
and from careless nursery at-tention.
And occasionally either dis-ease
is contracted innocently in places
where it is least suspected. All such
persons need protection. As a matter
of fact, these innocent persons are
very apt to suffer more severely in
case they become infected than those
who are familiar with the nature and
effects of syphilis and gonorrhea and
who know that they have been ex-posed
to infection.
Persons who are uninformed con-cerning
syphilis and gonorrhea and
innocently exposed to infection do not
have this protection. Consequently,
such persons may not as a rule seek
early diagnosis and early treatment,
both of which are so necessary to
prevent the disastrous effects of
these diseases when they go untreat-ed,
or when treatment is unduly de-layed.
Nature does not take into consid-eration
the manner in which infec-tion
was contracted. Whether infec-tion
occurs when folly lures or when
the witchery of the season entices;
whether it occurs after known or af-ter
innocent exposure to the disease;
whether it occurs among young girls
or young boys who, when thrown
willy-nilly into the whirlpool of life,
and motivated by one of the most
powerful and subtle forces of nature,
break through the warning signals of
danger; or whether it occurs to the
rich or the poor, the learned or the
ignorant, the saint or the sinner, the
spark is fanned to the flame just the
same.
As long as there are persons with
venereal disease in its infectious
stages, there is an ever potential dan-ger
to all those whose lives they
touch. It must be emphasized, how-ever,
that there is practically no dan-ger
to those persons who refrain
from willful exposure to infection
and who are intelligent enough to
observe good rules of personal hy-giene.
Each normal individual is endowed
with his due share of intelligence and
judgment. Yet in spite of that we
have traffic ordinances with lights on
every corner to guide the motorist
who, if he is able to drive a car,
should be able to guide it success-fully
through traffic. But the law,
like a stern and thoughtful parent,
sees to it that the driver, whether he
be capable or not, follows the lights.
January, 193Jf The Health Bulletin 11
There is no disgrace attached to these
laws, and they are more or less cheer-fully
obeyed. The shunted pariah,
venereal diseases, are far more dan-gerous
than the reckless driver, more
far-reaching than cancer and tuber-culosis,
and more devastating than
both of them combined. Yet many
people are too often prone to ignore
the warning signals of these diseases,
and of which so many people have
been reluctant to talk about openly
and frankly.
There can be only one reasonable
attitude toward the venereal diseases.
They are dangerous and deceptive
communicable infections that should
and must be considered on the same
basis as other infectious diseases.
And they must be stamped out if
man's most precious heritage—good
health—is to be protected and pre-served.
Only by being well informed
on these diseases, and, being well in-formed,
speak about them frankly
and forcefully in the proper circum-stances,
can this be accomplished.
People are more and more adapting
their thought to the conditions of a
changing world. Happily, this is true
also with respect to the venereal dis-eases.
As recent as a decade ago it
would have been considered a breach
of good manners to have mentioned
the venereal diseases in public in the
unadorned terms of syphilis and gon-orrhea.
Since then there has been
an ever increasing tendency to regard
these diseases as serious communica-ble
infections, concerning which the
public is not only constantly seeking
information on measures of preven-tion
and treatment, but, in many in-stances,
is demanding that they be
brought under control.
This emancipation of thought, to-gether
with a constant growing pub-lic
interest in the venereal disease
problem, constitutes one of the great-est
social gains in recent years.
Eating Habits
By Ernest A. Branch, D.D.S., Director Division of Oral Hygiene
YOU remember when you were a
child, your mother was con-stantly
telling you not to touch
the stove. You will also remember
that the warning carried little weight
with it until you learned once and for
all and for yourself just why you
must not touch it, and if touched
what dire and dreadful results fol-lowed.
That is the best way on earth
to learn that fire burns, but costly
—
very costly.
Public Health has a much harder
time of it than a mother, and many
of the evils and dangers against
which it warns are not as sudden as
getting burned. There is one thing
to be said for fire: it burns immedi-ately,
and with one such experience
that lesson is learned for life. With
this as illustration, it is obvious that
Public Health must warn and hope,
and keep on warning and keep on
hoping. With even more children
than the Old Woman Who Lived in
a Shoe, and a great number of them
grown-up children, what is it to do
except to keep after them?
And it must teach them not just
the simple lessons which carry with
them so strong a moral, but must in-struct
them so as to live not merely
longer lives, but more abundant lives,
and teach them how to keep well, and
by keeping well, being happy, in-stead
of dragging around, half-sick
and with a grouch. It must also
teach that the effects of neglecting
health are not so immediate, per-haps,
as the pain of a burn, but are
much more far-reaching and more
crippling in the end.
What if a tooth fell out every
night when you were "too tired to
brush your teeth"? That is drastic,
of course, but if it were true, then
before long there would be so many
horrible examples that we would
soon learn that lesson. It usually
takes so long for neglect to show
that we think we are safe and con-sole
ourselves by saying, "One more
12 The Health Bulletin January, 1934
night won't matter," "I just can't
get Johnny to eat turnip greens and
coUards," "You know, I just have to
force milk down Sally," and "I am
so outdone with little Rachel about
her eating. You know I have reached
the point where I almost hate to go
to the table because we have to beg
and coax Rachel to eat the things
she ought to have, and I do wish you
would tell me how to get her to eat
foods that will make teeth and
bones."
Well, that is just the thing we
want to talk to you about, because if
you could see little Rachel's mouth,
you would find it is literally shot to
pieces so far as teeth are concerned.
She is about five years old, pale, anae-mic,
and does not like to get out
and romp and play with the other
children. Her mother says she is full
of cold nearly all the time; her
breath is bad. Now, if we could get
the entire picture, I suspect we would
find that her mother and dad are just
about as careless in their health hab-its
as little Rachel. The truth of the
whole business is, the mother has
two or three dead teeth in her mouth
and evidences of pyorrhea, and she,
too, is not in the best of physical
health and is a little picayunish about
her eating. Upon questioning, we
find that she and the older mem-bers
of the family were eating at the
table at the same time Rachel was
present, and the older members eat-ing
any and everything they wanted
at any and all times of the day, but
insisted that Rachel must not eat this
or that, but should eat thus and so.
If we expect the child to eat the
proper food, and like it, then we
should adjust our diet to suit this
new condition, and do the same thing
and brag about it and like it, and the
child will follow our example. It is
a mistaken idea that the child does
not notice the difference between our
teaching and our practice.
It has been figured out and we
know just how much calcium and
phosphorus is needed daily for a
growing child, for an adult, and for
the expectant mother. We also know
that there is more available lime (or
calcium) in dairy products than in
other sources, and there is an abun-dance
in green leafy vegetables. Yet,
when the daily ration is evaluated for
minerals, we find that in what is
considered the best regulated of
homes the diet is inadequate in these
tooth- and bone-building materials.
It seems almost like slander to say
that some people use better judgment
in the feeding of their hogs, chickens,
and cows than they do in feeding
their children, and they know more
about "growing mash" for your
chickens and what it should contain
than they do about the necessary
foods to build good teeth. This
should not be, and it is the purpose
of your State Board of Health to
teach the child in our schools a few
of the fundamental things about
foods, food values, and proper health
habits, and to teach oral hygiene
through demonstration. If we can
reach the child and make our teach-ing
acceptable and educationally
sound, we feel confident of eventu-ally
reaching the mother, even
though we have to wait for a new
generation.
This may seem an old story to
some of you, for we have told it so
many, many times. We expect to tell
it again and again, because it is
through repetition that we learn.
Won't you examine your child's
mouth, and if he or she is in need of
dental attention, consult your dentist
immediately? If your children are
not eating foods that supply tooth
and bone-building material, won't
you see that they do? Won't you
look at your mouth and see if you
need dental attention, and if you do,
consult your dentist about your own
mouth? If you are not having the
right kind of food in your diet, it
would be well to look after this also.
The Dental Division of your State
Board of Health is anxious to im-prove
mouth health conditions.
A total of sixteen hundred and fifty-two
North Carolina citizens died of
cancer during the year 1932. The
question now is how many such deaths
may be prevented in 1934.
Jamcary. 193.'f The Health Bulletin 13
North Carolina Turns Over a New Leaf
In Public Health
By M. B. Cheatham
CALL it a New Deal or say that
North Carolina is turning over
a new leaf in public health, or
call it what you will, but at any rate
public health work in the State is mak-ing
the greatest strides it has done
for many a year. The State Board of
Health is pushing a program to use
Federal relief funds for sanitary
projects extending from Murphy to
Manteo. Malarial swamps are being
drained, thousands of privies are be-ing
constructed or repaired, school
and dairy sanitation are being im-proved,
and new water and sewerage
plants are being built in various
parts of the State.
Towns, counties, and individuals
are giving the sanitary program en-thusiastic
cooperation—and rightly
—
because everyone stands to gain and
no one to lose by it. Improved health
conditions will of course benefit the
whole community as well as the indi-vidual
on whose property the im-provement
is made. The individual
or the community is getting neces-sary
or desirable work done at the
cost of only materials and inciden-tals,
with labor and expert supervi-sion
furnished free. The neediest
cases in each community cooperating
will be taken from the relief rolls
and made wage earners, and the
money they make will be spent with
the butcher and the baker, and if no
longer with the candlestick-maker, at
least with every other kind of trades-man
or professional man in the com-munity.
The plan, briefly, is this: The State
Board of Health will furnish from its
own staff trained sanitary engineers
who will supervise the work; labor,
to be recruited as far as possible
from local relief and reemployment
rolls, will be paid for from Federal
relief funds allocated to the C.W.A.,
leaving only the cost of materials and
incidentals to be paid for by the
householder or community. Larger
projects, such as swamp drainage or
the construction of water or sewage
plants, may be financed through the
Public Works Administration, which
makes an outright grant of 30 per
cent of the cost of labor and materi-als,
and loans the balance at 4 per
cent, instead of the usual 6 per cent
interest which such loans usually
carry. By this method of financing
the town saves at the very outset
one-fourth the total cost of the proj-ect
(30 per cent of labor and mate-rial
costs amounting to approximate-ly
25 per cent of the total cost), and
further savings become evident each
year of the amortization period as a
result of the low interest rate
charged. Smaller projects, such as
privy construction, are handled
through Civil Works Administration
assistance providing for the cost of
labor.
The State Board of Health hopes
to carry out malarial control projects
in about thirty counties and privy
construction projects in all the State's
one hundred counties. Work has al-ready
gotten under way in several
counties, and additional counties are
rapidly swinging into line. Figures
tabulated November 15 showed 13
municipal waterworks and sewerage
projects in the State already ap-proved
by the P.W.A., while prelimi-nary
work for 31 additional similar
projects was under way towards get-ting
the applications approved. Other
applications have been made since,
but at the time this issue of The Bul-letin
went to press later figures for
the whole State were not available.
Before beginning privy construc-tion
work on a State-wide scale, the
State Board of Health sanitary engi-neers
made a series of careful experi-ments
to determine the most econom-ical
and at the same time most ef-
14 The Health Bulletin January, 193^
fective method of securing perfection
of details.
In order to use Federal relief funds
on private property, such work must
be shown to be clearly in the public
interest. For this reason cooperation
of all property owners is necessary.
To repair one privy while those
around it are left insanitary would be
of doubtful public value, but to make
all privies in a community sanitary
would obviously be of value to the
community.
For the privy construction work
and the malarial control projects the
State is divided into five main dis-tricts,
with subdivisions of from five
to ten counties each. Each district is
under the supervision of a staff sani-tary
supervisor of the State Board of
Health. Labor is to be recruited lo-cally
from relief or reemployment
rolls. Local supervisors will be, so
far as possible, trained sanitarians
recommended by the local relief ad-ministration
and approved by the
North Carolina Emergency Relief
Administration. The State Board of
Health is not handing out jobs; its
function is the training and super-vising
of local personnel.
The plan of procedure is to organ-ize
work in one community of each
district under a State supervisor, and
as soon as it is in successful opera-tion
to call in other prospective local
supervisors from adjoining counties
for a training course, after which
they will return to their respective
communities to organize work along
similar lines. Local supervisors are
required to hand in daily and weekly
reports of the work done to the State
Board of Health.
P.W.A. loans amounting to more
than two million dollars for sanitary
projects in the State have already
been approved, according to an an-nouncement
released November 2 6 by
Dr. H. G. Baity of Chapel Hill, State
engineer for the P.W.A. Halifax and
Davidson counties and the Waccamaw
district sought loans for drainage
work amounting to $156,234. Loans
totalling close to two million dollars
for water and sewerage plants have
been made to Durham, Granite Falls,
Southern Pines, Siler City, Columbia,
Carolina Beach, Reidsville, Fayette-ville,
Charlotte, Randleman, Frank-lin,
Gibsonville, and Winston-Salem.
Other towns had made applications
which had not been approved at the
time these figures were released.
Amoebic Dysentery
By J. C. Knox, M.D., Asst. Epidemiologist, North Carolina State Board of Health
IN the July issue of The Health
BuiiETiN attention was called to
the dangers of outbreaks of dis-ease
resulting from attendance at the
World's Fair in Chicago. This warn-ing
was specifically against typhoid
fever and smallpox. Recently the
State Board of Health was notified by
the U. S. Public Health Service that
there had occurred in Chicago an
outbreak of amoebic dysentery, result-ing
in 18 5 cases of the disease and 19
deaths, all told, and in the finding of
193 carriers of endamceba histolytica
among the food handlers in that city.
These patients lived in all parts of
the United States and Canada and
are not confined to Chicago or vicin-ity.
The U. S. Public Health Service
also asked that the various boards of
health, both State and local, should
be on the alert for cases of this dis-ease,
especially with the purpose of
locating any case with source of in-fection
traceable to Chicago.
Citizens of this State who visited
the World's Fair should seek medical
advice as early as possible upon the
development of dysentery, even
though mild, for only by thorough
laboratory examinations of a fresh
stool can the accurate diagnosis of
amoebic dysentery be made. There
is a tendency for recurrent attacks,
any of which may be very severe.
CAUSE. Amoebic dysentery is
caused by a unicellular parasite of
the protozoa class; in other words, it
.Ja7iuary, 193.'f The Health Bulletin 15
is a one-celled animal. It is capable
of independent motion by changing
its shape to throw an armlike pro-jection,
pulling itself along in this
manner. This organism has been
found chiefly in the tropical and sub-tropical
areas; however, there is
probably a greater incidence in our
northern climates than we have been
aware of. A few of the physicians in
North Carolina have been finding this
disease in this State for a number of
years, which leads us to believe that
if it were more closely looked for we
would find a greater prevalence in
North Carolina.
SOURCE OF INFECTION. Proba-bly
the greatest source of infection is
from the intestinal discharges from
a carrier of the disease. Unless the
organism is in the encysted or non-motile
form it is not able to cause
the disease in another person. Un-cooked
foods seem to be a great
source of the infection, if handled by
such a carrier. The hands are con-taminated
while at stool and the non-motile
form of the organism is trans-ferred
to the foods that are eaten
raw, while such foods are in the
process of preparation. The disease
is, therefore, chiefly limited to family
outbreaks, especially if the mother
is the carrier. It was determined in
Chicago that the present outbreak
was due to food handlers who were
carriers of the organism. Water may
also be a source of the disease. The
interval between exposure and devel-opment
of symptoms may be a matter
of days or weeks.
PATHOLOGY. In man the large
intestine is the chief site of involve-ment.
The majority of the cases run
a chronic course with intermittent
diarrhea or dysentery of varying in-tensity,
but at any time in such cases
the exacerbation may be very serious.
In the recent outbreak in which
death followed, many of the cases
were undiagnosed, for it simulated
appendicitis or other acute surgical
conditions in the abdomen. Intestinal
hemorrhage or perforation of the
bowel, with a resultant peritonitis
either localized or general, may be
encountered. Abscesses of the liver
occur frequently.
SYMPTOMS. The onset may be
mild or severe. In the acute attacks
the onset is usually sudden, with a
severe pain in the abdomen and a
desire to defecate. Vomiting and nausea
may occur. The diarrhea is serious.
Fifteen to forty stools may occur
within the twenty-four hours, first
with mucus, later containing blood
and shreds of intestinal mucosae.
There is usually very little fever pres-ent.
This condition may clear up af-ter
three or four days and become
more chronic, or any of the above-named
complications may occur.
Many cases are thought to be ap-pendicitis,
due to the intense pain in
the appendiceal area, for the large
bowel at that point is oftentimes
quite extensively involved. There
may be a chronic infection with the
organism and the patient not be
aware of it.
DIAGNOSIS. The diagnosis of the
disease is only made by laboratory
examination of the stool and finding
the amoeba in the motile form; how-ever,
the reports on several of the
cases that have died recently from
the Chicago outbreak show that the
amoeba was not found in the stool
and the diagnosis was made only at
autopsy. A trained eye can pick up
the amoeba very quickly, if present,
but some practice is necessary.
As soon as the diagnosis is made,
active and vigorous treatment should
be instituted by a physician. If the
treatment is begun early, recovery
usually takes place rapidly, even in
the severe attacks.
After recovery has taken place one
should have frequent examinations
of the stool to determine if the
amoeba is present in its encysted
form. One who develops into the
carrier stage is a source of danger to
the immediate family or to anyone
eating food prepared by this individ-ual.
Such a carrier should not be
allowed to engage in the handling or
preparation of foods for public con-sumption.
Personal hygiene is of
paramount importance.
16 The Health Bulletin Jan%ary, IdSJf
Physicians and tlie local health de-partments
should inform the State
Board of Health of all cases of
amoebic dysentery in their immediate
vicinity. If dysentery should occur
in anyone who has recently visited
Chicago, he should consult his physi-cian
for a microscopic examination.
Ignorance More Malignant Than Cancer
CANCER IS CURABLE!
North Carolinians on Saturday
were given assurance of that from
one of the greatest authorities in the
world on the dread malady, Dr. Jo-seph
C. Bloodgood, professor of clini-cal
surgery and director of the Garvin
Experimental Laboratory in Johns
Hopkins University, who spoke at
Wake Forest to 200 physicians and
dentists of North Carolina.
Cancer is curable, but there is an
important condition attached to this
promise. Cancer is curable "if we
could get the correctly informed pa-tient
to the correctly informed and
equipped physician and dentist" in
the early stages of the disease.
In other words, the greatest ob-stacle
to the cure of cancer today is
not the lack of scientific knowledge
as to how to treat the disease, but
the ignorance of the sufferer and the
ignorance of the physician. Granted
the conjunction of an intelligent and
informed patient and an intelligent
and properly equipped physician, can-cer,
if discovered in time, may be
cured, while cancer of the skin, the
mouth, and the cervix may be pre-vented
altogether.
In view of these facts it is a re-markable
commentary upon the State
of North Carolina, where every year
thousands die of cancer, that there is
not, it was stated, one institution
equipped for the treatment of all
kinds of cancer. This in itself is evi-dence
that in North Carolina there is
lacking that informed mind in both
patient and doctor which Dr. Blood-good
makes almost as much a specific
for the cure of cancer as salvarsan is
for syphilis or quinine for malaria.
The North Carolina State Medical
Association is leading in a tremen-dous
work in launching a five-year
cancer control program in this State.
Wisely, too, the association is begin-ning
its program with the education
of the doctors themselves. The more
difficult task of creating an informed
public will follow gradually but
steadily.
North Carolina's problem in fight-ing
cancer, as in many other prob-lems,
is one of ignorance. Cancer is
curable, but it will not be cured until
that even more malignant disease,
ignorance, is wiped out both among
the illiterate and the educated. Some-times
ignorance walks under a col-lege
degree, and occasionally the un-lettered
are less ignorant. In cancer,
as in childbirth, two problems of edu-cation
are of almost equal impor-tance:
insistence upon not only the
qualifying, but also the continuing
education of the doctors, and an
equal insistence upon the necessarily
more gradual education of the people
in matters of personal as well as pub-lic
health.
—
ler\t free to arwj citizen of the State upoa request !
Entered as aecond-elusa matter at Poatoffice at Raleigh, N. C, under Act of July 16, 189^
Published rtuynthly at the office of the Secretary of the Board, Raleigh, N. C.
Vol. XLIX MARCH, 1934 No. 3
MOUTH HEALTH TEACHIIVa
School Dentist Using Stereopticon In Mouth Health
Teaching In the Schoolroom
MEMBERS OF THE NORTH CAROLINA STATE BOARD OP HEAI/TH
Carl V. Reynolds, M.D., President _ _ -Asheville
G. G. Dixon, M.D Ayden
S. D. Craig, M.D Winston-Salem
H. Lee Large, M.D _ „ Rocky Mount
J. N. Johnson, D.D.S Goldsboro
H. G. Batty, Sc.D _ Chapel HiU
W. T. Rainby, M.D _ _ Fayetteville
HuBCRT B. Haywood, M.D Raleigh
Jahbs p. Stowe, Ph.G _ _ _ - Charlotte
Executive Staff
Jambs M. Parrott, M.D., Secretary and State Health Officer.
G. M. CoopEa, M.D., Director Division of Preventive Medicine.
Wasrbn H. Booker, C.E., Director Division of Sanitary Engineering.
Ernest A. Branch, D.D.S., Director Division of Oral Hygiene.
John H. Hamilton, M.D., Director Division of Laboratories
and Vital Statistics.
M- V. ZiEGLEX, M.D., Acting Director Division of County
Health Work.
D. F. Milam, M.D., Acting Epidemiologist.
FREE HEALTH LITERATURE
The State Board of Health publishes monthly The Health BtJLLErnif
which will be sent free to any citizen requesting it. The Board also has
arailable for distribution without charge special literature on the follow-ing
subjects. Ask for any in which you may be interested.
Adenoids and Tonsils
Cancer
Coinstipation
Chickenpox
Diabetes
Diphtheria
Don't Spit PIae«rda
Eyes
Flies
Fly Placards
German Measles
Health Education
Hookworm Disease
Infantile Paralysis
Influenza
Malaria
Measles
Pellagra
Residential Sewage
Disposal Plants
Sanitary Privies
Scarlet Fever
Smallpox
Teeth
Tuberculosis
Tuberculosis Placard*
Typhoid Fever
Typhoid Placards
Venereal Diseases
Water Supplies
Whooping Cough
SPECIAL LITERATURE ON MATERNITY ANT) INFANCY
The following special literature on the subjects listed below will be sent
free to any citizen of the State on request to the State Board of Health,
Raleigh, N. C.
Prenatal Care (by Mrs. Max West)
"Our Babies"
Prenatal Letters (series of nine
monthly letters
)
Minimum Standards of Prenatal Care
Breast Feeding
Infant Care. The Prevention of
Infantile Diarrhea
Table of Heights and Weights
Baby's DaQy Time Cards : Under 6 months
;
5 to 6 months ; 7, 8, and 9 months ; 10,
11, and 12 months; 1 year to 19 months;
19 months to 2 years.
Diet List: 9 to 12 months; 12 to 15
months ; 15 to 24 months ; 2 to 8
years ; 3 to 6 years.
Instructions for North Carolina Midwives.
CONTENTS
PAGE
School Dentistry in North Carolina - - 3
State School Dentists With the North Carolina State Board of Health _ „ 4
Mouth Health Teaching in the North Carolina Schools - 5
School Dentists and School Children „ - •- 7
It Is Playtime When First Grade Children Go to the School Dentist 9
Ultimate Aim of Mouth Health Programs - 11
How Mouths of Children in Hall-Fletcher Junior High School Were Made Dentally Fit- 12
What Our Friends Have to Say About the Mouth Health Program _ — 13
Building Our Teeth - - 14
Mouth Health Programs in the Counties (Map) — 16
Vol. XLIX MARCH, 1934 No. 3
SCHOOL DENTISTRY
IN NORTH CAROLINA
FOR this month's issue the veteran editor of THE HEALTH BUL-LETIN
is vacating his chair to Dr. Ernest A. Branch, who for the
past five years has been Director of the Dental Division of the State
Board of Health. Dr. Branch and his capable assistant, Miss Mary
Batchelor, have written or assembled all the material published this
month.
On the 10th day of July, 1918, the editor of THE BULLETIN, as
Director of the Department of Medical Inspection of Schools, em-ployed
six young dentists and started them out with portable dental
equipment to teach the school children of the State the meaning of
mouth health and care of the teeth. The first work was commenced
on the above date in a small rural school in Nash County.
Since that beginning sixteen years ago the work has never ceased
during school hours. It has been one of the greatest contributions to
health and happiness of the people of this State ever inaugurated \yy
the State Board of Health. WTien the work started 95 per cent of all
school children in the State were in need of immediate dental service.
Fewer than five out of each hundred who needed dental work had
ever seen inside of a dentist's office. Today in many of the schools
of the State everj' child in need of dental attention has had it; and
in many schools 50 per cent or more of the children in certain grades
have perfectly cared for teeth. The work has been strictly educa-tional
and has succeeded in reaching the parents as well as the chil-dren.
One of these dentists has demonstrated one or more times in
every public schoolhouse in North Carolina. Dr. Branch is a teacher
of great ability, and since he took over the direction of the work has
succeeded in arousing widespread interest among the dental profes-sion
and the people. One of the great satisfactions of the editor of
THE HEALTH BULLETIN is the knowledge that he was able to
inaugurate, organize, and execute this great work from the beginning
in 1918 and for eight years thereafter; and that the organized dental
profession enthusiastically aided him in every way in the support of
the work.
The work has been encouraged and supported through appropria-tions
by the Legislature, county and city boards of commissioners
and education, by industrial corporations, and individuals. The
demonstration work has been confined to school children between
the ages of six and thirteen, but the influence has been felt by all
of them. Every class of children among both races has been influ-enced.
If Dr. Mayo's statement that 80 per cent of all the ailments
of humans may be attributed to mouth origin is correct, then the
next generation of North Carolina should be a healthy people.
STATE SCHOOL DENTISTS WITH THE N. C. STATE BOARD OF HEALTH
1. Dr. D. W. Dudley
2. Dr. H E. Butler 6. D8. W. I. Farrell
3. Dr. Vaiden Kendrick 7. Ernest A. Branch
4. Dr. L. E. Buib Director
9. Dr. J. A. Oldh.\m
10. Dr. Gates McKaughan
11. Dr. a. D. Underwood
5. Dr. M. R. Smith 8. Dr. a. J. Pringle 12. Dr. L. R. Thompson
13. Dr. a. C. Early
14. Dr. a. L. Wootbn
15. Dr. W. L. T. Miller
16. Du. Robert M. Bell
;
17. Dr. L. C. Holliday .
Mouth Health Teaching in the North
Carolina Schools
DR. GEORGE M. COOPER, a physician connected with the North Caro-lina
State Board of Health, was, so far as we are able to determine,
the first public health official to place dentistry in a public health
program. This was in 1918. In 1919 North Carolina was one of the first
states to have a dentist as a member of the State Board of Health, and in
1931 was the first State to enact a law making a dentist a member of every
county board of health. Dr. James M. Parrott, upon his election in 1931 as
State Health Officer of the North Carolina State Board of Health, dignified
the profession in North Carolina by making the Division of Oral Hygiene
a separate and distinct entity of the Board of Health.
The purpose of the Division of Oral Hygiene of the North Carolina State
Board of Health is not
to operate free dental
clinics, but to teach the
value of oral hygiene
in the prevention of
disease.
The dentists in this
department are trained
as teachers and are
capable of going into
any classroom and
teaching the subject of
oral hygiene, which is
based on foods, food
values, and proper
health habits. In our
didactic teaching in
the classroom visual
methods are used,
namely, models, plac-ards,
blackboard draw-ings,
stereopti con
slides, etc.
D e n t al corrections
are also used as a
means of visual in-struction.
The neces-sary
dental work is
done for as many chil-dren
as possible, pref-erence
being given to
grade repeaters. In
this part of our pro-gram,
before any work
begins, the child is
Dr. G. M. Cooper shown his own mouth
a physician and Director of Preventive Medicine of the North in a large mirror and
Carolina State Board of Health, who was the first public health ^jjg existing conditions
official in the United States to place dentistry in a public health , . , _, .
program. explained. This gives
The Health Bulletin March, 19S4
the dentist-teacher an opportunity to
reemphasize the health truths
brought out in the classroom teach-ing.
Of course, the number worked
for is reduced to a minimum because
we do not reach as many with actual
dental work in this way as we would
had all of our time been spent at the
chair, but those who are fortu-nate
enough to be used for demon-strative
purposes have all necessary
dental corrections made in the very
best manner possible. Those who re-quire
dental attention and do not
receive it in school are urged to visit
their family dentists.
This method of teaching allows the
grade teacher to correlate Mouth
Health with "reading, writing, and
'rithmetic," history, geography, spell-ing,
etc. It is easily tied in with the
projects and activities of farm
agents, home demonstration agents,
4-H clubs, calf clubs, home economics
work, and vocational agriculture, as
these are all closely associated with
foods, food values, and proper health
habits.
The financing of this activity is
borne jointly by the State Board of
Health and local budgets. Local bud-gets
include schools, parent-teacher
associations, civic clubs, etc.
The director of the Division of Oral
Hygiene is a dentist, and in addition
to directing the activity, he spends
the major portion of his time lectur-ing
in grade schools, high schools,
teacher-training institutions, parent-teacher
associations, women's clubs,
and civic clubs.
—
The Journal of the
American Dental Association.
The Best Mouth Health Record In the State. Only One Cavity In One
Tooth In the Entire Group. All Homes Represented
Have Cows and Gardens
March, 1934 The Health Bulletin
School Dentins and School Children
By Mary S. Batchelor
SAY there is nothing new under
the sun and believe it if you will,
but prepare for a rude awaken-ing
when in these enlightened days
and times you see the younger gener-ation
dancing with pleasant anticipa-tion
over an impending visit to the
dentist! That is new!
To those of us who are no longer
classed as children, there are memo-ries
which, if conjured up, can still
cause cold sweat to stand upon our
brows and make horrible shivers start
at our feet and shake us to the core.
Such a memory is that of the pulling
of loose teeth not so many years ago.
Don't you remember the method in
vogue—the string tied to th